Level 3 Certiﬁcate in Personal Training · • give teaching points that lead to the improvement...

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Level 3 Certificate in Personal Training:Programming & Delivering

Personal Training

Performance Training Academy 2

Contents

Roles and responsibilities of a personal trainer ………………………………………. Page 3

Know your client ………………………………………. Page 15

Approaches to training ……………………………………….. Page 36

Programming Personal Training ………………………………………. Page 99

Introduction

The role of the personal trainer is multi-dimensional. It is a role that demands a depth of knowledge in a range of areas, a broad skill set across a variety of different fitness disciplines, an impeccable attitude and the ability to relate to a diverse group of people.

This chapter will provide an overview of the teaching cycle and the role of the personal trainer at each stage of this cycle. Subsequent parts of the manual provide a more in-depth knowledge base to enable you to perform your role at each stage of the teaching cycle and to meet the needs of the specific client with whom you are working.

The Advantages of Personal Training

As well as being a potentially lucrative career and a highly enjoyable and rewarding way of earning a living for the instructor, personal training also provides many benefits for clients. Some of these include:

• There is regular contact between you and your client to increase motivation and adherence.

• Personal training enables frequent reviews of the programme and your client's progress (either formal - eg, scheduled assessments, or informal eg, observation and discussion).

• lndividualised programmes are created to meet specific goals, likes and dislikes, thereby being more client-centred. This increases satisfaction and reduces any potential injury risk because the programme has been ‘tailor-made’.

• Continuous feedback can be provided by your client, enabling exercises to be adapted accordingly.

• Goals can be achieved more quickly and efficiently.

• Programmes can be designed around specific information gathered from clients about their individual lifestyle, health status, psychological needs and physical ability (posture, functional, core, flexibility, strength, etc.).


Roles and Responsibilities of a Personal Trainer

What Makes an Excellent Personal Trainer?

It is difficult to quantify exactly what makes a personal trainer ‘excellent’. Qualities such as confidence, approachability, personality and the ability to build a good rapport and develop empathy with clients separates trainers who are viewed as ’excellent' from those who are merely ‘competent’.

Some of the basic teaching skills you should possess include being able to:

• demonstrate and explain a variety of exercises safely and effectively

• give clear verbal instructions

• give teaching points that lead to the improvement of a client's technique

• observe client performance

• monitor a client's response to exercise using appropriate methods (eg, rating of perceived exertion, or RPE)

• make corrections to unsafe or ineffective technique

• ask questions and gather feedback

• encourage and motivate clients

• offer alternative exercises to progress or regress activity

These basic skills are studied and practised across the Level 2 planning and instructing units. They are important in ensuring that exercise is carried out safely and effectively and that a reasonable level of client care and support is maintained.

At Level 3, a personal trainer is expected to be able to demonstrate a significantly higher level of teaching and client care and support skills, striving towards 'excellence’ rather than simply achieving basic ‘competence’. Excellence can be achieved through experience, reflective practice and commitment to continuing professional development.

The Teaching Cycle

The teaching cycle provides an overview of all the broader aspects of the role of a personal trainer. It also offers a framework for reflective practice. If a session does not go to plan, it could perhaps be that insufficient time was spent on gathering information to identify the client's needs, or perhaps an aspect of planning was overlooked. Regardless, you can only improve and develop if you take time to review your role. The teaching cycle can help to inform structure and improve practice. Each aspect of the role will be discussed in more detail throughout this manual.


A brief overview of the personal trainer role

Identifying client needs - this involves gathering information from the client and may include:

• screening and informed consent (PAR-Q, interviews, providing information such as referral or deferral, etc.)

• carrying out health and fitness assessments (blood pressure, body composition, flexibility, functional ability, etc.)

• collecting personal information (client motivations, lifestyle, physical activity history, fitness goals, barriers to exercise, commitment, readiness to change, etc.)

• agreeing the working contract (number of sessions, cost, times, cancellations etc.)

Planning and designing a programme - this involves the preparation needed to deliver a personal training session and will include consideration of:

• environment: indoor, outdoor, gym, pool, office, home, space, temperature, terrain, obstacles, etc.

• equipment: cardiovascular (CV) or resistance training (RT) machines, vibration equipment, steps, bands, free weights, or environmental equipment, clothing, portable equipment, etc.

• individual: programming to meet the individual's needs and goals

• health and safety considerations specific to the environment and equipment used (eg, risk assessment and management)

All information gathered will need to be recorded and a programme card designed to meet the client's specific needs.

Delivering and instructing a programme - this involves using interpersonal skills and teaching strategies to deliver a session to meet the client's goals and needs. These include:

• interpersonal skills: communication style, building rapport, empathy, being non-judgemental, listening, questioning, body language, clothing and appearance (wearing clean sportswear and appropriate footwear; long hair tied back, jewellery removed and maintaining a healthy body appearance, etc.)

• teaching strategies: demonstration, explanation, questioning, monitoring intensity, observation, alternatives, gathering feedback, etc.

• exercise and approaches: different training approaches (supersets, intervals), proprioceptive neuromuscular facilitation (PNF), etc., for different components of fitness (muscular strength endurance, or MSE, cardiovascular, or CV, flexibility, motor skills, etc.); training in different environments (client's home, workplace or exercising outdoors or in a swimming pool); and using a variety of different equipment (eg, portable, stability equipment, resistance and cardiovascular machines, free weights, etc.)


Reflective practice and evaluation - this involves taking time after the session to consider how effectively the session met the client's needs and includes:

• gathering feedback from the client

• evaluating own practice

• gathering information from other sources (eg, a mentor)

Reflective practice entails planning to do something (eg, a training session with a client), doing it (delivering the session), reflecting on it (thinking about what worked and what did not work using all available information) and action planning (deciding a course of action for improving the session in future).

Reflective Practice

The Reflective Cycle Diagram

A very basic example of this model in practice would be:

• The trainer plans a session for the client based on the information gathered.

• The trainer delivers the session, but the client suggests that some of the exercises are too easy.

• The trainer thinks about the session, taking into account all the feedback and information gathered from the client (eg, were the exercises too easy and if so, which ones?).

• The trainer uses this information, makes a decision and adapts the exercises the client found easy (if deemed appropriate) by using the principles of progression, etc.

Action planning - this involves creating strategies to improve the future work with the client(s) and to develop the instructor professionally. This may involve:

• reading and research (using reputable internet sources and books, journals, etc.,

• working with a mentor

• attending training and workshops (continuing professional development, or CPD, and courses)

• additional qualifications

• registering the development of own competence (eg, registration with the Register of Exercise Professionals - REPs)


Some of these aspects are explored in a little more detail in subsequent paragraphs.

Experience and reflective practice

The most reliable way to develop personal training practice and skills is to work with a variety of different clients, to evaluate your working practice honestly and to constantly seek ways to improve your knowledge and skills from each working experience.

As part of the reflective practice, it is essential to obtain feedback from clients after each session and, when necessary, to seek advice from other knowledgeable people, such as a mentor or another experienced personal trainer. Client feedback, coupled with your own reflections and discussions with a mentor, can help you to evaluate your progress and identify specific actions and strategies for continued development.

Working with a mentor

An excellent way to improve training and delivery skills is to work with a more experienced and successful personal trainer and to use them as a ’role model’ and ‘mentor’. Observing a skilled trainer and practitioner working with different clients allows you to recognise the interpersonal skills they use to relate to their clients and can help you to identify specific skills that you may also wish to develop In your own practice.

Having an experienced personal trainer as a mentor gives you access to someone who can address any questions and concerns you may experience when working with different clients. An experienced trainer can share their knowledge, act a sounding board, offer advice and guidance and help you to develop your knowledge, skills and attitude towards working with a range of clients. They can also guide you to appropriate sources of additional information (REPS, American College of Sports Medicine, or ACSM), The National Institute for Health and Clinical Excellence, or NICE, etc.). Their feedback can be used to help with reflective practice and can inform your continued professional development.

Qualifications

Part of professional conduct is to be qualified to deliver the specific session and work with a specific client group. The Certificate in Personal Training enables a trainer to work with apparently healthy people and give occasional advice on training to specialist groups (eg, older adults, disabled people, antenatal and postnatal women and people on exercise referral schemes), using guidelines specified at Level 2.

If you wish to work regularly with specific specialist groups or deliver specific types of programme (aqua, Pilates, circuits, etc.), then you should also aim to gain qualifications in these areas.

A range of qualifications are listed on the YMCA Awards website, www.ymcaawards.co.uk, and also on the REPs website,www.exerciseregister.org.uk.

REPS also provide descriptions of a number of working roles in the industry. These occupational descriptors clearly state the roles a Level 3 personal trainer can and cannot fulfil.


http://www.ymcaawards.co.uk/

http://www.exerciseregister.org.uk/

Listening skills

A personal trainer should develop excellent listening skills so they can effectively interpret the information their clients offer that relate to their training goals, aspirations and motivational needs. If the client presents a specific need or goal that is not within your remit, you should refer the client to other services. Listening to a client's goals will ensure they receive a quality service (value for their money) and that their wants and needs are met. It can also help you make sure you work within your professional boundaries.

Listening fully means you can respond appropriately to the feedback and messages (verbal and non-verbal) that each client provides. It enables you to establish your client's preferences and the time they have available, from which you can agree an appropriate way of working that suits the client (ie, a client-centred approach). Observing the client's gestures and body language can help you to gain a better understanding of them and their readiness to begin working towards their goals. One such example is that a client may express a willingness to make specific changes verbally but may unconsciously shake their head as they speak. This may indicate that, at some level, they are not ready or willing to make the changes being discussed. It can be helpful for you to highlight this to the client, explore their responses (and resistance) and suggest that other strategies can be explored that may be more appropriate to help them achieve their goals.

Variety of exercise approaches and environments

It is important for a personal trainer to have extensive knowledge of a wide variety of exercises, approaches and environments, enabling them to adapt to the needs of different clients. The more extensive their knowledge, the more adaptable they can be.

It is not necessary to use every exercise and approach with all clients. These exercises and approaches should be considered as part of your basic ‘toolbox’. The art of an excellent personal trainer is to be able to select the most appropriate exercise or approach from their toolbox to suit the wants and needs of a specific client. A ’multi-directional lunge, combined with a medicine ball transverse plane rotation’ may be a fabulous exercise, but it would be completely irrelevant and inappropriate for a client who is 35kg overweight, who feels intimidated in a gym and who primarily wants to pedal steadily on an exercise bike and read a book.

The modern personal trainer should also be able to apply a variety of approaches in the context of alternative environments to the gym. Many potential clients may not wish to use gyms, so the ability to use other indoor and outdoor areas is a key skill for a personal trainer. In addition, working independently means avoiding the overheads/costs involved in working within a corporate gym. If using alternative environments, however, you have an additional duty of care to plan and risk assess the areas you will be using. Considerations will include:

• indoor areas and shelters (in case it rains heavily)

• terrain and gradients

• traffic

• situation of trim trail apparatus and benches

• toilets

• emergency planning and procedures


Indoor areas and shelters

When the weather is cold and/or it is raining, it is an advantage to have access to an indoor space where the client can warm up, perform muscle-conditioning exercises and cool down. It is also useful to know where there are places of shelter if the weather changes - eg, a bus shelter or a coffee shop (carry some spare cash!).

Terrain and gradients

It is useful to know where gradients occur so they can be used appropriately throughout the session in order to maximise the effectiveness of the programme.

If you are using a park, wooded area or country lane, there may be areas that are very uneven or become boggy when the weather is wet, which may be best avoided. Alternatively, you can encourage your client to bring a change of footwear and socks during wet conditions or when using off-road walking paths.

Traffic

When walking or running on the streets, the problem of traffic and number of roads to be crossed needs to be considered. If there is no pathway on a country lane, for example, keep on the right-hand side to face oncoming traffic (unless going around a blind corner). The level of traffic may vary dramatically at different times of day, and what may be a quiet stretch of road at mid-morning may be a very busy area in the early evening. Be as familiar as possible with each route.

If you have to cross a road, ensure you cross over with the client and only when the road is clear. It is your responsibility to arrange safe crossing, so it is advisable to use pedestrian crossings whenever possible.

Trim trail and benches

It is increasingly common to find trim trails or outdoor gym areas in public spaces. These can be incorporated in to sessions to provide a variety of muscle conditioning and other exercises. It is also essential to know where there are benches for resting if the client becomes unexpectedly tired.

Toilets

If you are using a park, or are close to a high street, it is useful to know where the closest toilet facilities are at different points in the walk. Ideally, visit the toilet before you leave for the session (and encourage your client to do so as well), but be prepared for any eventuality.

Emergency planning and procedures

When working from a leisure centre, GP surgery or health centre, there is usually a written emergency plan that provides guidance on how to respond to and manage an emergency. A freelance personal trainer will need to prepare their own emergency plan. It should address:


• procedures, including contact details of local emergency services or the nearest doctor, how to contact them, how to direct emergency services, how to manage the incident, emergency first-aid procedures, accident report book, etc.

• supplies and equipment, including access to a first-aid kit, etc.

• qualifications to administer first aid and CPR. It is important that you hold a current certificate in cardiopulmonary resuscitation and first aid if working independently

Emergency routes, telephones and emergency contacts

It is essential to know of shortcuts back to the starting point if a client starts to feel unwell or to have a telephone available (with reception) to call an emergency service.

First-aid kit

When working outside, it is useful to carry a portable first-aid kit. All first-aid kits must be checked on a monthly basis.

Insurance

All personal trainers must have professional indemnity and public liability insurance. Professional indemnity is a safeguard from lawsuits and claims made against professionals, and public liability safeguards against a member of the public injuring another person while exercising.

Permission

It is sometimes essential to gain permission to exercise in certain areas. If you are in any doubt, it is wise to check with the local authority to find out further information about how to proceed.

Clothing and footwear for working outside

It is essential to consider the clothing and footwear necessary for exercising in a variety of weather conditions. You should make sure you inform the client before they take part in a walk.

Weather

• Cold weather

• Wear several layers so they can be taken off as you warm up, rather than just one thick item.

• Clothing nearest the skin needs to allow moisture through, while trapping the air that you have warmed.

• A thermal vest/undershirt (skin) would be ideal, covered by long-sleeved T-shirt and a sweatshirt with sleeves that can be tied around the waist.


• Consider a waterproof and/or wind proof jacket that can be either tied around the waist or folded up and placed in a belt bag.

• In very cold weather, wear appropriate hat and gloves to ensure that heat is not lost through the head or extremities.

• Windy weather

• Wear clothing that has a drawstring to keep the wind from blowing through it.

• Wet weather

• An essential additional layer when exercising in wet weather is a waterproof, breathable outer garment (jacket and trousers) that is not restrictive. This will also reduce the chill factor of the wind.

• Warm weather

• Wear something loose to allow air to circulate freely. Modern ’wicking' fabrics that allow moisture to evaporate quickly are much preferable to cotton, which stays wet when sweaty.

• Shorts and a vest are great, but they may leave more vulnerable skin types unprotected, and it is generally recommended that all skin types are kept covered at certain times of the day.

• Suntan lotion and sunblock can be used to protect against the sun's rays. In addition, wearing a hat or cap can help to protect the head and shade the face and eyes.

• Sunglasses may also help to ease the strain on the eyes. It is inadvisable to partake in any form of strenuous outdoor exercise during the hottest time of the day: doing so may lead to dehydration, sunstroke and heat exhaustion.

• Drink plenty of liquids and clients should be encouraged to replace any fluid loss as soon as possible, preferably during the walk itself.

• A water bottle carried in a small rucksack or on a waist belt is advisable.

Safety in the dark

If you have to use public roads in the dark, then some form of light-reflective clothing is essential.

Shoes

There is a range of specialist shoes available that cater specifically for exercising outdoors. A standard cross-training shoe (one that is suitable for both indoor and outdoor exercising) might be a good investment.


Risk-assessment checks for working in different environments

Part 4 explores a range of approaches to training, including using different environments and equipment to minimise risks while maximising workout efficiency.

Range of teaching strategies

A personal trainer should be able to teach new exercises and improve exercise performance using a variety of methods and techniques to suit different client needs and learning styles. These include:

• demonstration

• verbal and visual reinforcement

• whole-part-whole (breaking down complex exercises into parts, before asking clients to perform the whole)

• add on (building exercises sequentially)

• analogy and visualisation

What are the hazards? Who might be at risk? How can the risk be managed?

What further action is needed to manage the risk?

List all the potential hazards in the environment.

Consider whether the potential hazards pose a risk to you, your client(s) and/or the general public.

• What precautions have been taken?

• What information can be given to your client(s)?

• What can you do to manage risk further?

• Can the risk be removed? Is there a lower risk alternative?

• Can you prevent exposure to the potential risk?

• Can you reduce exposure to the potential risk?

Examples:

• Not being clearly visible in the dark

• Traffic - particularly on country roads

• Limited space at home or in the work place

• You and your client• You, your client and

other members of the public

• Wear high-visibility clothing

• Face the direction of oncoming traffic (except on blind bends)

• Use portable equipment designed for use in restricted spaces to ensure the workout is effective without compromising safety

• Train in the daylight where possible

• Train at quieter times of day and wear high-visibility clothing

• Offer the client the option of going outdoors for some cardiovascular training and do the static training (muscular fitness and flexibility) at home


When selecting a teaching approach, you should be aware of your client's needs and preferred learning style. If you are unsure what learning styles are and would like to find out more about how to incorporate them into your teaching, try putting the phrase ‘learning styles’ into an internet search engine.

The working contract

Before beginning any work with your client, you will need to negotiate a contract of work (the terms and conditions for the work). Listed below is the kind of information that you would need to include.

• an overview of your role (as per the teaching cycle)

• your commitment as the trainer - eg, to arrive and finish on time and to dress appropriately, etc.

• the commitment required of your client - eg, to attend arranged sessions, to take part in other activities, to keep a diary, etc.

• how many sessions you will conduct (in total or each week)

• the cost of each session

• the time of the sessions and where they will take place

• dates for any reassessment and programme reviews

• how much cancellation notice is required from you and your client and whether fees will be charged if insufficient notice is given

• the level of contact in between sessions

• whether your client would prefer to restrict contact to your pre-arranged session (if, for example, they want to keep their training private from their family)

• how you and your client would prefer to be contacted (telephone, text, email, social media, etc.)

• details of the records you will keep (screening, fitness assessments, programme cards, etc.) and how they will be used

• to what extent information about your client will be kept confidential and when this confidentiality would need to be breached (eg, you should explain that if your client presents a medical condition, you are duty-bound to gather information from their GP and to adapt training accordingly)

• that, in cases where confidentiality needs to be breached, you will inform your client why this is the case and get their written permission

• the date the contract was agreed and signatures to demonstrate commitment from both parties


Personal safety

Personal trainers will have to meet with lots of potential clients. It is not advisable to meet a potential client for the first time in a private place (eg, your home or theirs). It is essential that you consider your own personal safety at all times. Below are some suggestions about how you might approach this.

• When you are meeting a potential client for the first time, arrange to meet in a public place - eg, a sports centre.

• Always keep a diary detailing who you are visiting and when, along with contact details.

• Let someone know where you are going and when you expect to return.

• Trust your instincts. If you feel uneasy for any reason, you should respect this and act appropriately.

There are a number of organisations that make recommendations for personal safety in different environments, including the Suzy Lamplugh Trust (www.suzylamplugh.org).

Professionalism

Part 1 has introduced some of the dimensions of the role and responsibilities of a personal trainer. Common to them all is professional conduct. A good way to demonstrate your commitment to maintaining professionalism is to join an agency that oversees standards in the fitness industry - eg, the Register of Exercise Professionals (REPs).

All trainers who join REPS are expected to read and sign its code of ethical practice and to adhere to its guidelines when working with clients. The REPs website lists a number of reputable training providers that offer continuing professional development (CPD) opportunities and additional support. See www.excericeregister.org for more information.

Professional conduct will be explored in greater detail in subsequent sections of this manual.


http://www.excericeregister.org

Part 2 - Know your client

Introduction

Part 2 covers everything that an instructor will need to know about your client(s) in order to provide them with the best possible training programme to meet their needs and goals.

Client profiling

Successful personal trainers use a client-centred approach, which involves finding out as much relevant information as possible about the client so that their needs and wants can be catered for. In a competitive market, customer care is absolutely crucial, and generic programmes that fail to take into account individual requirements are unlikely to make the grade.

With this in mind, it is important to build a comprehensive general profile of the client before starting to gather more in-depth information and developing a programme. Things to consider may include:

• the client's age and gender

• their medical and health history, including whether they've had any injuries

• their history and experience of exercise

• their reasons for wanting to start an exercise programme

• any barriers to exercise: both intrinsic (something internal - eg, low starting fitness levels, an old injury or lack of motivation) and extrinsic (external factors, eg lack of time)

• whether the client has access to a supportive network of family/friends

• their access to other resources (money, facilities, usable environments, equipment, etc.)

• the client's time constraints

There may be many other factors that will contribute to the client's profile, and it is important to use a variety of methods to try and tease them out, such as interviewing and questionnaires.

All of this information will be fundamental in making good decisions about how to work with the client, including selecting appropriate fitness tests, setting realistic goals and formulating a client-centred programme. Strong communication skills are crucial for you to be able to extract this information from your client, and this is examined in more detail in the following section.

Effective communication

It is important to understand the skills that are necessary to consult effectively with your clients. These include being able to build rapport with people, accepting a client's views and beliefs, having empathy and being able to listen and reflect on what you've been told. Honing these skills will increase the effectiveness of all contact you have with a client, but equally important is the ability to recognise when there is room for improvement.


Good communication skills on the part of the instructor will enable the client to develop their knowledge, keep them motivated and can positively impact their attitude and behaviour. Moreover, good communication skills can be used in other aspects of your life - as well as in your future career.

Potential barriers to effective communication include:

• poor listening skills

• inappropriate non-verbal communication (body language and facial expressions)

• uncompromising patterns of thinking (prejudice and perceived ideas)

• making assumptions

• labelling and stereotyping

• lack of trust

• lack of clarity

• personal style

• social and cultural differences (age, gender, social class, ethnicity, language)

• learning difficulties

Attending

Attending is the ability to focus on one individual at a time, using both your observation skills and your thought processes. In order to attend well, you should look directly at your client, your thoughts should be tuning in to what he or she is saying and your body language should be attentive. Distractions - such as mobile phones - should be removed.

Attending involves actively listening in order to fully understand an individual's thoughts and perceptions. It is well recognised that this skill can be used in group facilitation, as well as in one-to-one discussions.

Gerard Egan (1998) used the acronym SOLER to describe effective attending. This stands for:

Squarely - Face the client squarely; a posture that indicates involvement.

Open - Adopt an open posture to communicate openness and availability.

Lean - Lean slightly towards the client, as if to say ’I'm with you’ rather than ‘I'm disinterested’.

Eye - Maintain eye contact, as if to say ‘I want to hear and understand what you are saying’.

Relaxed - Adopt a relaxed posture.

Body language is not an exact science; however, it is still a useful tool for gathering additional information about a client in order to help them change their behaviour. Certain postures are often associated with particular behaviours or attitudes: eg, it is commonly interpreted that sitting with your arms folded conveys defensiveness. However, it might actually mean that a client with folded arms is cold, or simply that he or she is comfortable in that position.


Listening

Being able to listen effectively to other people is an important skill. Most of us believe that we listen to everything all the time. Sometimes, however, we listen but we don't actually hear. As we absorb information from others, we attempt to form mental pictures and add to the information by drawing on our own experiences. However, this can actually interfere with listening, as it takes attention away from the information that is being given, perhaps because these mental pictures that have been created in the forefront of our minds distract us, as they can perhaps be more interesting.

Strong listening skills allow individuals to hear more of what is said and to capture more information. This will help to identify any issues that are restricting or preventing behaviour change. For example, your client might tell you how much they enjoy a particular exercise or activity, while at the same time shaking their head: in this case, their words and body language do not match. Good listening skills will enable you to identify conflicting messages such as these and to act accordingly.

Reflective listening

During most conversations, it is fairly easy to listen and respond to content as it unfolds. However, miscommunication is more likely to occur if you respond before you have heard and understood all the information your client presents. This also often results in conversations taking longer because your client will have to spend more time explaining what they mean. If you focus on constructing responses while a client is still talking, or if you find yourself ‘drifting off‘ during a conversation, you have stopped listening.

There are two distinct types of listening - active listening and reflective listening. Active listening involves repeating or paraphrasing what someone has said back to them, in order simply to confirm that you have heard what they have said. Reflective listening, on the other hand, involves two stages: first, trying to process and understand for yourself what someone has said and, second, offering the person's idea back to them to confirm that it has been correctly understood. To put it another way, reflective listening is like making an educated guess about the meaning of what a client has said, then checking with them that your guess is right.

It is best to avoid responding with questions, because they require your client to reflect on what they have said and may cause them to doubt whether they have managed to get the correct meaning across. Questions may also cause a client to act defensively. Responding to your client with a statement, however, shows that you have listened carefully and tried to understand what they have told you.

The language and tone you use is also important. Make sure your voice is calm and even and choose non-critical words that show you empathise with your client. Your intonation (the way your voice rises and falls in a sentence) is also important. If your voice 'goes up‘ at the end of a sentence, it gives the impression that you are questioning your client, even if you are not asking a direct question. A level tone - making your voice ’go down’ at the end of a sentence - is typical of a statement and gives the impression that you are confident and authoritative.

Reflective listening is a way of checking the meaning rather than assuming you know what is meant. However, when using reflective listening, avoid underestimating the importance of ‘you’. Placing emphasis on ‘you’ focuses on the individual and the behaviour, but may not allow the ‘individual’ to disassociate from the area they want to change. Performance Training Academy 17

This might all sound quite passive and imprecise, but it is important that you engage fully in the process of reflective listening in order to get maximum benefits for you and your client. It is crucial that you filter what seems to be unimportant and pay attention to what you think is significant. It can be difficult to know what to attend to and what can be ignored, but reflective listening is a subtle skill that will develop over time and with practice. As you become a more competent reflective listener, you will naturally find yourself using words and phrases that parallel your client's meaning.

Empathic responding

Empathy is the ability to understand the client's experience from their perspective. It is one of the most important skills in building rapport. You must acquire the ability to understand your client's reasons for wanting to become more physically active and to develop good communication skills to identify any barriers to exercise. Below are some suggestions to help you develop these skills:

• Look out for non-verbal behaviours (body language).

• Identify whether these non-verbal behaviours match your client's verbal communication.

• Think about whether your client's behaviour creates and/or supports an underlying issue.

• Be aware of your own non-verbal reactions to your client and how they might be interpreted.

• Listen to and identify the content of the information your client is providing.

• Compare the experiences (content) your client tells you about with their previous experiences and/or patterns that you have already identified.

• Ask yourself: ‘How would I feel if I had experienced what my client has told me about?’

Building rapport

Building rapport is important in order for effective communication to take place. To establish rapport with a client, it is essential to understand what they are like before moving on with the rest of the session. Rapport is built using more than just conversation, and body language is also important. To build rapport with a client, it might be worth considering mimicking his or her posture. For example, if they are sitting in a relaxed position, it might be appropriate to do so yourself.

It is important to remember that the tone and pace of your voice play a part in developing rapport, as well as the language that you use. Try to avoid using words and phrases just because they are fashionable or using terms that are unfamiliar to your client; doing so could make you both feel uncomfortable.

It is also important to consider your choice of clothing. When you are getting ready for a session with a client, think about the following:

• What image does the clothing you are wearing project?

• What would be suitable clothing for a professional personal trainer?


Finally, and most importantly, remember the following two rules:

• Rule 1 = Establish rapport with your client.

• Rule 2 = Attempt nothing else until you have done so.

A good way to establish rapport is the ’typical day’ approach - trying to understand what is involved in the client's typical day. You could ask your client to describe what they do during a typical day, starting with when they get up. The theory behind this approach is that the client will disclose where and when physical activity could be incorporated into their daily routine.

Once rapport has been established, the next step is to set an agenda for the session(s). This will identify time constraints and other issues that need to be discussed. Your client may want to talk to you about a number of things, but your role is to identify and focus on what are the most important issues.

Some clients may feel quite anxious and worried that you are going to tell them what to do, so they might want to spend time talking to get a better understanding of what the sessions will involve. If you notice this reaction from your client, it normally indicates that you have not yet managed to establish rapport. If this is the case, you will need to go back to Rule 1 above. However, when you have managed to build rapport, avoid jumping straight into a discussion about behaviour change, as your client may not be quite ready for this yet.

Your main role is to identify possible areas for change. When you are dealing with a new client for the first time, the following points may help you:

• Gather as much information as possible to help you understand your client's situation.

• Avoid closed questions - those that require a straight ‘yes’ or ‘no’ response - because they don't leave the door open for your client to talk openly.

• Instead, use open-ended questions - those that do not require a specific answer - to engage your client in open discussion and enable them to guide the direction of the conversation. This can be extremely useful if they have specific areas they want to discuss that would not be addressed by direct questioning.

• Set an agenda early and encourage your client to contribute. This allows you to set areas for discussion, as well as providing an opportunity to establish rapport with your client.

Here are some examples of ways to start a conversation that will encourage your client to open up:

• ‘Describe your current level of physical activity.’

• ’Tell me what you have noticed about your health since you became more active.’

It is important to remember that any methods you use to encourage your client to talk will be of particular benefit in the early stages of the conversation. However, just because you have tried to provide the opportunity to talk, it does not necessarily mean your client will be open, especially if the area of discussion is of a personal nature (eg, they may feel uncomfortable talking about their weight, so any discussion around that may be met with resistance).


In the examples above, however, the discussions are related to physical activity, and, if appraoched with a non-judgemental and positive tone of voice, are more likely to encourage your client to share information with you.

Physical gestures

In everyday conversation, we tend to use hand gestures and signals for every two or three words we say, in order to emphasise the point we are trying to make. The position of the palms can send signals to confirm or contradict meaning. Generally speaking, palms facing upwards, conveys an open and positive message, while palms facing downwards can be interpreted as dismissive or negative.

Proximity

In order to respect someone’s individual space, you must be aware of the dynamics of personal and physical proximity - the area and territory that surrounds us. The parameters of personal space can be determined by a number of things, including culture, personality, experience, the type of relationship between people and the specific situation. Invading someone’s personal space can make them feel uncomfortable and anxious, sometimes so much so that they feel they have to move away so they can recover their personal space.

Think about walking into a lift or onto a train. When that space is empty, you are more likely to feel comfortable anywhere in the lift or train carriage. But as more people join you, people move to find space and territory that is theirs. As the lift or carriage becomes fuller, people reflect in their body language that their personal space is being invaded. For example, you might notice that arms fold, heads drop and eye contact is minimal as people look to the floor or ceiling. Some people close their eyes while travelling on a busy train - sometimes to snooze but more often as a way of maintaining their personal space in response to having that space invaded.

Social and cultural norms dictate the appropriate parameters of personal space. Generally speaking, British culture calls for personal space of between 30-40cm (12-16 in.) to retain mutual respect and comfort. Some social situations require you to get closer to another person - eg, if you meet someone for the first time and shake hands. In this case, people often tend to naturally lean towards each other as they make contact before withdrawing again to re-establish a respectful and comfortable distance.

As a personal trainer, understanding proximity and personal space is crucial to professional practice. Most of us naturally read signals and subconsciously choose an appropriate distance to put others at ease. Being aware of your client's own preferences — especially within the fitness environment - will help you to develop this skill.

If you have to correct a participant's technique, the way in which you approach them is vital. Use eye contact, friendly facial expressions and open body language (think about the position of the palms of your hands, as above). Wherever possible, make sure you are at the same physical level when you correct your client - eg, if he or she is on the floor, kneel beside them. If you tower above them from a standing position, you risk sending a signal that you are domineering and unfriendly, and this could make your client feel quite uncomfortable. It will also make your correction seem more critical and less private. However, always be aware that while you are in this situation, you are in your client's territory, so be prepared to respectfully back off if they are uncomfortable with you encroaching on their personal space. Performance Training Academy 20

Physical touch

Touching during conversation is commonplace in many cultures. In British culture, however, it is typically only appropriate within established relationships. This is crucial to consider in scenarios such as within a gym.

It is sometimes necessary for fitness instructors to correct a client's posture or technique through touching and gently placing them into position - eg, in yoga and Pilates. While this is a reliable form of correction (if used with positive and encouraging language), it is important that you always ask your client's permission first before approaching to touch them or placing them into position. If they indicate - either verbally or in their body language - that they are uncomfortable, you must respect that and find another appropriate way to guide them.

Voice

Using your voice appropriately is an important factor in presenting yourself well. Two useful approaches to effective use of your voice are known as ’PICTURE' and 'MERK’. They are both covered in more detail in the Level 2 manual, but they are broadly outlined below:

PICTURE Pitch Inflection Courtesy Tone Understanding Rate Enunciation

MERK Modulate Emphasise Repeat Keep eye contact

The effects of effective communication

Within the process of behaviour change, feedback is essential in the communication process. It allows the instructor to see whether a change in behaviour has taken place, by acting as a check to see whether the new behaviour is in place and the old behaviour has been addressed. Feedback also allows an instructor to quickly evaluate and reflect on the communication process to see whether any immediate adaptations can be made to increase the likelihood of the behaviour change continuing. The use of learning resources or tools can also help with communication.

Key points

• Effective verbal and non-verbal communication is vital for maintaining a positive relationship with a client.

• Body language can both build up and break down communication barriers.


• Listening, clarifying and demonstrating empathy are important factors in effective communication.

• People have different boundaries in relation to physical proximity to others. It is important to respect individual personal space.

Health screening and informed consent

The ’physical activity readiness questionnaire’ (PAR-Q), originally developed by the Canadian Society for Exercise Physiology, provides a quick and easy method of identifying someone who may be put at risk by increasing their level of physical activity. The PAR-Q should be completed as a basic screening for existing medical conditions and/or symptoms of any possible medical conditions. A thoroughly completed PAR-Q should always be kept on file and may provide protection from possible future legal action against an instructor.

You will find an example PAR-Q form in appendix 1, and you can download an original free of charge from the Canadian Society for Exercise Physiology’s website (www.csep.ca/publications).

Any client who answers ’yes’ to any of the questions on the PAR-Q should get medical approval before starting a programme of physical activity or exercise. Their GP will need to fill in a medical clearance form to confirm it is safe for the client to exercise. An example of this form can be found in appendix 2.

You should also refer a client whose PAR-Q reveals no physical barrier to exercise but whose needs would be better met by another professional with more relevant qualifications, such as specialist instructor or physiotherapist.

As well as the Par-Q, you should ask your client to complete an ‘informed condent’ form, which, as the name suggests, confirms that they have understood the potential risks and benefits of their planned programme and are happy to go ahead and take part. You will find an example ‘informed consent’ in appendix 3.

In addition to the Par-Q and informed consent form, you need to take some physical measurements and perform posture analysis.


http://www.csep.ca/publications

Theories and concepts of behaviour change

At Level 2, the basic models of behaviour change were discussed (for further details, refer to the Level 2 manual). This section will build on the knowledge gained at Level 2.

Determinants of behaviour change

A wide range of theories have been developed on all aspects of human behaviour. Each theorist has attempted to explain why individuals behave in certain ways in given circumstances. Although most of these theories are successful in their diagnosis of some aspects of human behaviour, no single theory can explain all aspects, as the individual is a very complex being.

There is a variety of models that have been developed to help explain both cognitive (thoughts) and active (actions) behaviour patterns. Some models are more user-friendly than others and act as a good tool for practice, whereas some are very complex and more theoretical. This does not mean you need a deep knowledge and understanding of each model, but a basic understanding of how and why the models were developed will help you to decide on the approach that will best suit each individual.

Understanding the theory of behaviour change alone is not sufficient. It is also fundamental to understand how different factors interact with, and affect, the individual.

The major factors affecting physical activity have been identified by psychologists as:

• demographic and biological

• psychological

• behavioural attributes and skills

• social and cultural

• physical environment

• physical activity characteristics

Identifying the major factors that affect individuals allows us to develop an approach that encourages positive health behaviours, such as increased exercise participation and adherence.

When developing an approach, it is important to look at the range of factors that affects the individual. This will ensure that each factor has been correctly analysed and that the correct adaptation and/or model for behaviour change has been used.

The following table shows a range of factors (often called determinants) that affect the participation in, and adherence, to physical activity.

KEY:

+ = weak or mixed evidence of positive association with physical activity

++ = repeatedly documented positive associations with physical activity

Source: Adapted from Trost et al (2002)Performance Training Academy 23

Determinant Associations with activity in a supervised programme

Associations with overall physical activity

Education + ++

Gender ++

Genetic influences ++

Income/socio-economic status ++

Enjoyment of exercise + ++

Outcome expectancy values + ++

Intention to exercise + ++

Self-efficacy ++ ++

Self-motivation ++ ++

Self-schemata for exercise ++

Activity history during childhood +

Activity history during adulthood ++ ++

Dietary habits ++

Past exercise programme ++ ++

Process of change +

Skills for coping with barriers +

Decision balance sheet + +

Group cohesion +

Physician influence ++

Social support from friends/peers + ++

Social support from partners ++ ++

Social support from an instructor +

Access to facilities, actual + +

Access to facilities, perceived +

Home exercise equipment +

Enjoyable scenery +

Frequently observed others exercising +

Hilly terrain +

Neighbourhood safety +

Satisfaction with facilities +


Adoption and maintenance of physical activity

Over the past two decades, successive governments have been encouraging people to adopt and maintain a pattern of physical activity. However, even with public awareness through education, advice and behaviour modification, it is still a very challenging task.

The overall aim of physical activity is to improve an individual’s health and lifestyle, as well as to reduce the burden of inactivity on health services. Encouraging the mass population to incorporate activity into their lifestyle, whether or not they understand its importance, is dependent on willingness to adopt and maintain physical activity on an individual level.

Models of behaviour change

Organisations such as health authorities use a variety of methods or models of behaviour change to tackle the challenging task of encouraging people to adopt and maintain activity. Some of these models were developed more than a century ago and have since been modified by psychologists.

Initially, many of these methods were developed and used in the field of psychology, rather than as means to encourage physical activity and exercise. Therefore, only a small part of each model may be appropriate for a chosen situation. With experience, you will be able to extract the approaches that work best for your clients and to develop skills for using them to assist in behaviour change.

The most common models for behaviour modification are:

• the theory of reasoned action (Ajzen and Fishbein, 1975)

• the theory of planned behaviour (Ajzen, 1988)

• the health belief model (Rosenstock,1966)

• the health locus of control (Wallston, Wallston, Kaplan and Maides, 1976)

• social cognitive theory (Bandura,1983)

• stage-based models

• the transtheoretical model (Prochaska and DiClemente, 1982)


The theory of reasoned action

This theory aims to understand what influences an individual to act, even when they may or may not feel in control of that behaviour.

The theory of reasoned action is based on how an individual's intention to perform an action depends on their attitude towards it. For example, if a person perceives a particular behaviour as positive, their attitude towards the chosen behaviour is positive, and vice versa. This is also true if influential people in the individual's life (partners/family/friends) have a positive attitude towards that person adopting such behaviour. This theory demonstrates that people are rational and make systematic decisions depending on the information available. It shows that individuals consider the implications of their actions before acting.

The theory of reasoned action also takes into account that both internal and external influencing factors affect a person's decision making. Such factors include their domestic/physical situation, environment, attitudes towards exercise and health, health issues (if applicable), health education and the advice and attitude of others and/or the media. People may also consider the perceived benefits of and perceived barriers to the behaviour. Once all of these aspects have been assessed, the person may or may not decide that they will benefit from the behaviour, in this case, becoming more active.

The theory of planned behaviour

The main problem with the theory of reasoned action is that it does not explain how, if the behaviour and its influencing factors are not under the individual's total control, adoption and maintenance of a new behaviour are unlikely. In response, Ajzen developed the theory of planned behaviour, which takes into account behaviour, attitude and the control - or total lack thereof - of factors surrounding the behaviour.

The theory of planned behaviour suggests that if an individual has no control over surrounding factors, they will be unlikely to adopt and maintain a chosen behaviour, regardless of whether they have a positive attitude. For example, a person plans to exercise and has a positive attitude to exercise, but feels that exercise cannot take place due to work/family commitments, etc. Or another example is that if friends or colleagues do not exercise, then an individual may feel pressured not to exercise, as not exercising is the normal behaviour within that specific society (subjective norm).

The health belief model

The health belief model aims to explain and predict health behaviours by focusing on people's attitudes and beliefs. It was first developed in the 19505 and is one of the most enduring theoretical models of preventive health behaviour. It was originally designed for a tuberculosis health-screening programme and was later used to study sexual behaviours that lead to sexually transmitted diseases, including HIV.

The health belief model has been described as a ’value expectancy’ model, which means the behaviour is based upon the value that it and its outcome will have to the individual. It is based on the assumption that a person will take action only if an adverse health condition can be avoided, and if the action can be conducted with ease and confidence. In other words, it is assumed that an individual will not comply with preventative health recommendations unless: Performance Training Academy 26

• Minimal motivation is required.

• They are provided with relevant information.

• They perceive that they are especially vulnerable to a health condition, or that the condition is particularly severe.

• They are particularly likely to benefit from taking action.

• They believe they have the ability to successfully complete the action.

For example, clients who perceive that they are susceptible to a health condition that could be prevented by taking up exercise are more likely to begin exercising than those who perceive that they are not susceptible. However, there are limitations to this model: factors such as cultural differences, socio- economic status and previous experience can all affect people's decisions.

It has also been suggested that the health belief model is flawed because it was developed to predict a single instance of a specific behaviour, as opposed to more than one instance of behaviour. For example, exercise is carried out over time (more than one instance); therefore, it may be unrealistic to expect this model to predict exercise behaviour.

The health belief model led to the development of the social learning theory (Rotter, 1966; Bandura, 1977), which considers some of these issues. Self-efficacy - the measure of one’s own ability to complete tasks and reach goals - is one of the major areas that the social learning theory focuses on. The theory looks at how self-efficacy can affect an action, such as participating in an activity, and therefore impact overall exercise adherence. For example, an individual will weigh up the advantages of giving up a particular behaviour (inactivity) to change to more positive health behaviour (activity).

Health belief model example: Gordon is a 60-year-old plumber who has been feeling unwell for a little while. He visits his GP, who confirms that Gordon has high blood pressure and raised cholesterol levels. An ECG shows that he is also at risk of developing angina.

The GP explains that the conditions are not a major concern if Gordon agrees to make some changes to his lifestyle. He recommends a reduced-fat diet and advises Gordon to increase his current level of physical activity by walking more often. Gordon has a family history of heart disease and recalls the negative health experiences of his brothers, and the GP confirms that if Gordon chooses not to act upon his advice, he may experience the same problems.

As a result of what he has been told, Gordon changes his diet immediately. He switches from full-fat to semi-skimmed milk and starts to eat less cheese and bacon. In order to increase his physical activity he starts to walk every day, devising different routes for different days to prevent boredom.

A follow-up appointment at a later date shows that Gordon's blood pressure and cholesterol have returned to normal levels.

The health locus of control

The health locus of control concept was initially derived from Julian Rotter's (1966) social learning theory. It refers to the degree of control that people believe they possess over their personal health. Performance Training Academy 27

Building on from Rotter's work, Wallston and Wallston (1978) developed health locus of control scales. They consisted of three scales:

1. Internal health locus of control (IHLC) - This is the extent a person believes that internal factors are responsible for their health/illness.

2. Powerful others’ health locus of control (PHLC) - This is the belief that health is determined by powerful others, or people who influence our choices.

3. Chance health locus of control (CHLC) - This measures the extent to which a person believes that their health/illness is a matter of fate, luck or chance.

More generally, 'locus of control’ measures indicate the degree of control (internal or external) an individual has over a particular life situation. Individuals who have an external locus of control may believe that everyone is conspiring against them to keep them in their current situation. They blame others for their situation by disassociating themselves from the issues they face and will attribute success to luck (similar to PHLC and CHLC). On the other hand, individuals who have an internal locus of control believe that they have control over their own destiny and are responsible for their own situation (similar to IHLC).

Building confidence

Although there is no real evidence to suggest that this model may be helpful in changing exercise behaviour, increasing an individual’s internal locus of control will lead to a more positive outlook on their health, which will lead to an increase in confidence. This increase in confidence and positive outlook may, in turn, lead to increases in exercise motivation and participation. Every individual has a comfort zone and any change in behaviour, however small, will challenge this. Once confidence is gained within a task or activity, an individual's comfort zone within that task and environment should be established.

To ensure that individuals feel comfortable within the exercise environment and are within their own comfort zone, it is important to build rapport with your client before anything else. Once rapport has been established, you can help your client to realise their goals and to gain confidence in the exercise environment. An increase in exercise participation, motivation and retention will follow, enabling your client to realise his or her goals for a healthier lifestyle.

The social cognitive theory

The social cognitive theory was developed by Albert Bandura in the mid-1980s from his studies on the social learning theory, which has been traced as far back as the 1800s and was later documented by Rotter (1966). The concept behind the social cognitive theory is that an individual’s confidence or belief in their ability to be successful will determine whether the individual will engage in that behaviour or not. For example, if a client believes that they can successfully become more physically active, or that they would be good at a certain activity, then they are more likely to try. If, however, they consider being physically active - eg, running a marathon - is beyond their capabilities, then they are unlikely to attempt physical activity. A practical understanding of the social cognitive theory models may help to encourage clients to participate and adhere to activity.


Self-efficacy

Self-efficacy is a person's belief that he or she can be successful at achieving an action. Self- efficacy is determined by the outcome expectation (how much value someone places on an outcome, such as climbing the stairs without being breathless) and the person's perception of their ability to be successful. Perception is often linked with past experiences; therefore, if an individual thinks that an action was previously successful and is confident in their ability to perform the action, then the action or behaviour will be successful.

The underlying principle of social cognitive theory is that the majority of behaviours are learned through social interaction, such as by observing and imitating other people. Bandura identified the three main variables to exercise participation and adherence as:

• Efficacy expectations: the individual has the confidence and the ability to perform — eg, to swim 10 lengths of the pool.

• Outcome expectations and/or values: the individual values and feels confident in the outcome - eg, feels confident in being able to swim 10 lengths of the pool.

• Past experiences: eg, the individual has previously swum 10 lengths or more.

Bandura recognised that self-efficacy was repeatedly identified as a determinant of successful behaviour modification in an exercise environment. Self-efficacy, he found, was influenced by the types of activity performed, the amount of effort expended and how much a person persisted in the face of obstacles.

In the context of physical activity, exercise participants will have different levels of self- efficacy regarding exercise and activity, but confidence and self—efficacy can be improved through a combination of experience, observation and knowledge. Bandura identified that it was possible to improve an individual’s self-efficacy in four ways:

1. Performance mastery - mastering an activity and improving performance in that activity

2. Vicarious experience - learning from other people's experiences and successes

3. Verbal persuasion - encouraging someone verbally

4. Emotional arousal - tapping into a person's feelings about succeeding in an activity

Performance mastery is achieved when an individual learns through personal experience. For example, an equipment induction that allows the participant to set up, select resistances and perform exercises with the correct technique may help to achieve performance mastery. It also provides an opportunity for the participant to practise the new activity while supervised.

Vicarious experience is learning from modelling other behaviours. Clients will improve in the performance of a physical activity if they see competent demonstrations by the instructor or other individuals similar to them.

Verbal persuasion develops self-efficacy via feedback. When feedback in the form of praise and technique correction is delivered in a supportive manner, the individual's performance will be improved and self-efficacy increased. Providing the feedback is given as soon as the activity has been accomplished, this will help the client to develop a belief in mastery of the performance.


Emotional arousal takes place when individuals are informed of the benefits of correct performance and continued participation. It also provides an opportunity to reinforce a client's goals. The belief of a positive outcome expectation is a key component of the social cognitive theory. For example, when we watch the London marathon, we see expert runners and ordinary people running side by side. When we see people like ourselves being successful, it encourages us to participate.

Successful performance

New health behaviours can be reinforced successfully if the individual is provided with an opportunity to engage in them. However, in order to help the individual be successful in the new health behaviour, it is important to find ways to help maintain that behaviour.

Physiological feedback

Instructors in the health and fitness industry may have some understanding and experience of various methods of fitness testing. But some of these methods may not be particularly useful for those who are new to exercise and may in fact discourage further participation.

However, explaining to your client what they can expect to feel while they exercise may be useful. For example, if you ask a regular exerciser to describe the feelings they are having while exercising, they will use statements such as 'l'm out of breath’, ’My legs feel heavy’, ’My muscles are burning’, ’My heart is pounding’, 'l'm sweating a lot’ or 'Tt feels difficult to breathe’. However, people who are not involved in regular exercise may not understand the physiological responses that occur during activity. To an inactive individual, therefore, these are feelings they normally only have when they are ill. If your client does not understand what may happen to their body during exercise, they may mistake these natural responses as signs that there is something wrong with them.

Stage-based models

In addition to the previous models mentioned, there are some theorists who suggest that changes in behaviour may happen in stages. These three stages are classified as:

1. antecedent (before you start)

2. adoption (when you start)

3. maintenance (keeping going)


Self-efficacy

Outcome expectations

Past experiences

Antecedent

Antecedents are stages that the individual goes through before they engage in physical activity. Any information about the benefits, cost and availability of exercise and activity will assist clients in deciding to adapt their current behaviour. It is imperative that you understand the advantages of becoming more physically active, as you will need to be able to give basic information about the benefits of exercise, avoiding the use of jargon or intimidation. It may also be appropriate to use role models (people similar to the client who have successfully changed) to help them in the process of changing a behaviour. Role models can be useful in helping others who are new to physical activity.

Previous experience can also be helpful in assisting people in adapting their current behaviour. This provides a historical context to the behaviour change that your client is looking to implement. Exploring someone’s previous attempts to become physically active allows you to discover what your client thinks of being more physically active, as well as ensuring that they continue with the positive behaviour change.

There are also other potential incentives for an individual to become more active, such as reducing the risk of illness and looking fitter and healthier. If a client has concerns about his or her weight, physical appearance or ability, it's important to be sensitive when recommending types and frequency of activity. Your client may wish to start exercising for just a few sessions each week, even though they might get maximum benefit from taking part in activity three or four times per week, so be mindful of this when setting out a programme for them.

Over the years, a good deal of research has been carried out on self-esteem and body image. Researchers have discovered that many people experience social physique anxiety, or SPA (Hart, Leafy and Rejeski, 1989). This is when an individual experiences anxiety in response to their belief that other people are evaluating their appearance or physique. Those who are described as having high SPA prefer to exercise at low to moderate intensities, whereas individuals who have low SPA prefer to exercise at high intensities. People in the latter category tend to exercise and take part in sport regularly. You may need to take this information into account when identifying activities that are suitable for your client. People exercise for different reasons; some choose to exercise for self-presentation - to look better - while others will participate in exercise for health and fitness. It has been found that those who exercise for self-presentation as opposed to health and fitness reasons are likely to exercise less often.

When you talk to clients about their reasons for becoming more physically active, pay attention to whether they talk more about health or appearance. For those who have high SPA, it is important to avoid activities that may emphasise performance against others. These individuals would probably prefer to use cardiovascular and resistance machines and may also prefer to exercise in the corners of a room or at the back of any group activities. They will also choose activities that do not emphasise body image.

Adoption

Adoption refers to the period during which an individual begins to include physical activity in his or her lifestyle, and in which opportunities to be successful and unsuccessful present themselves. At this stage, it is important to give ongoing support and positive feedback about your client's performance to build and reinforce skill levels and confidence. As previously discussed, an


increase in self-efficacy is vital if an individual is to move from the adoption stage to maintenance of the new pattern of behaviour.

Individuals who have been exercising for a certain period of time may consider themselves to be exercisers. This suggests that any intention to engage in activity has been reinforced by their experiences of success.

Maintenance

When an individual has been active for approximately six months, it may be appropriate to adapt any approaches that have been used. Your role at this stage is to provide support to encourage the pattern of behaviour. Monitoring and providing feedback will assist clients in maintaining their new behaviour. Ask your clients how they are getting on or maybe discuss other options or approaches they may want to try. Show interest in their current activities and be positive about how frequently they participate.

The transtheoretical model (stages of change)

This model was developed by Prochaska and DiClemente (1983), who studied large numbers of people and followed the process of change. Originally developed to assist in smoking cessation programmes, the transtheoretical model has been widely adopted to help change behaviour towards alcohol, drug use and physical activity. As a consequence of their studies, Prochaska and DiClemente began to see a general pattern demonstrating that individuals’ progress through definite stages of change when trying to alter a pattern of behaviour.

The stages of change model comprises three elements:

1. stages of change 2. process of change 3. self-efficacy

Each stage involves a specific role or action that must be mastered before successful behaviour change can be accomplished. The stages of behaviour change include pre—contemplation, contemplation, preparation, action, maintenance and termination. Relapse is also identified within this model and will be discussed later in this section.


Pre-contemplation Contemplation Preparation

ActionMaintenanceTermination

Pre-contemplation: Individuals in this stage are not physically active and are not considering becoming active within the next six months.

Contemplation: Individuals in this stage are not currently physically active but are considering becoming active within the next six months.

Preparation: Individuals in this stage have started to take part in some physical activity but not regularly. They intend to become more physically active within the next month or so.

Action: Individuals in this stage are engaging in physical activity, but have only started within the last six months.

Maintenance: Individuals in this stage are engaging in physical activity on a regular basis and have been doing so for at least six months.

Termination: The individual's old behaviour is now terminated.

As previously stated, this model has been used in contexts where the aim is to remove or reduce a negative behaviour and substitute and/or control a positive behaviour. Negative behaviours include smoking, excessive drinking, illicit drug use and binge eating. However, unlike these examples, physical activity is generally considered to be a process of taking something up rather than giving something up. Therefore, in the context of physical activity, the negative behaviour is often defined as physical inactivity, and the new positive behaviour is defined as physical activity and exercise - so, your client is taking up physical activity and giving up physical inactivity. It may be appropriate to use this description when speaking to your clients.

As individuals progress through the relevant stages, the opportunity for lapse and relapse is high. Lapse and relapse are considered normal processes when adapting a pattern of behaviour. Individuals will make several attempts at changing an old behaviour before being successful in the new behaviour. Each stage requires a different combination of cognitive and behavioural strategies to help people through the process of change. Research has identified that ’pre-contemplators’ (those who are inactive and have no immediate plans to change) have lower self-efficacy scores than ‘maintainers’ (those who have been regularly exercising for at least six months).

Research suggests that barriers to change will be different at various stages, depending on the individual and factors influencing them. Stage-based models can be useful in physical activity interventions. It is important to note, however, that a single approach or intervention will not work for everyone, so it is necessary to use a range of approaches that can be adapted to suit different people and their circumstances.

The simplicity of the stages of change model has made it appealing for people working in the fitness industry. However, for this model to be successful, it is important to dedicate resources and to offer supporting materials at each stage, to help people to progress to the next stage. This has been attempted in the USA (Marcus et al.), where materials have been produced to accompany each stage of change. UK programmes that are based on the stages of change approach - such as exercise referral schemes - have yet to follow suit.


The first two stages (pre-contemplation and contemplation) have a greater focus on cognitive processes (thoughts) than the third stage (preparation), which is a combination of cognitive and behavioural processes, whereas action and maintenance predominantly involve behavioural processes. It is important to understand that using behavioural strategies, or trying to move clients to the next stage before they have attempted some cognitive restructuring, will often lead to lapse and relapse.

Relapse prevention

According to research, the aim of relapse prevention is to identify high-risk situations that may cause the individual to choose an inappropriate behaviour over the desired behaviour. In the context of physical activity, it involves identifying situations that might cause a client to fail to attend sessions or to relapse into inactivity.

When these high-risk situations are not considered in advance, a lapse can occur. A lapse often leads to clients believing that they have failed in their attempt to change, which in turn increases the probability of additional lapses may occur, leading to a relapse to sedentary behaviour.

Stage of behaviour change

Characteristics Needs Appropriate initiatives

Pre-contemplation The client has little awareness of inactivity and the consequences of inactivity.

• Information about the problem

• Opportunities to personalise the situation

• National and local media

• Leaflets• Posters

Contemplation The client balances the potential benefits against the potential costs (time, money, effects on others).

• Opportunities for discussion

• Knowledge of the facilities and opportunities

• Cues to action

• Taster sessions• Promotional events

and campaigns• Advice from GPs

Preparation The client prepares to take action and then increases physical activity.

• Opportunities for participation

• Feedback on progression

• Discussion with exercise or health profession

• Exercise consultation

Action The client has recently become active on a regular basis.

• Feedback on progress

• Provision of a variety of opportunities and events

Maintenance The client has been regularly active for at least six months.

• Support to maintain the behaviour

• Club support groups • Co-participants

Termination The client no longer engages in the old behaviour.


Relapse prevention involves calling cognitive and behavioural processes into play to help the individual to cope with these situations. Research has found that 50% of people will relapse from a supervised exercise programme within the first 6-12 months.

Key points to behaviour change

• The major factors affecting participation in activity are demographic, environmental, influential people, culture, physical challenges of exercise, current skills and behaviour.

• Over the years, a number of different behaviour change theories or approaches have been put forward. Some of these have been used in the context of changing exercise behaviour, with varying degrees of success. These include:

• the theory of reasoned action • the theory of planned behaviour • the health belief model • the health locus of control • social cognitive theory • Stage-based models • The transtheoretical model • relapse prevention

• The most widely recognised model in the exercise industry is the transtheoretical model.

• Increasing self-efficacy is extremely important for increasing exercise motivation and participation.

• Patterns of adult behaviour are developed over a long period of time. Attempting to change behaviour can be difficult.

• When developing an approach to behaviour change, it is important to look at a range of factors that affect the individual.


Part 3 - Approaches to training

Introduction

Part 3 explores the range of different training methods, environments and equipment designed to suit different clients. At Level 2, the benefits of various types of training and the evidence-based research were discussed in the ’Principles of exercise, fitness and health’ unit.

This part will build on that knowledge from Level 2 and briefly revisit the Chief Medical Officer's guidance for health and the American College of Sports Medicine's recommendation for frequency, intensity, time and type of activity. It will examine how the different approaches to training can help clients to maintain and improve their health and fitness levels.

Cardiovascular training for health

Traditional exercise advice emphasises the importance of relatively vigorous physical activity, with the main objective being to develop and increase fitness over a short period of time. A 2011 report by the UK’s four Chief Medical Officers (CMOs) - called 'Start Active - Stay Active’ - sets out the following guidelines for physical activity for different age groups to stay healthy:

• under-fives -180 minutes every day once a child is able to walk

• children and young people (5-l8 year-olds) - a minimum of 60 minutes, and up to several hours, every day of moderate to vigorous intensity physical activity. This should include vigorous activity that strengthens muscles and bones on at least three days a week

• adults (19-64 year-olds) and older people (65+) - 150 minutes each week of moderate to vigorous intensity physical activity (adults should do some physical activity every day). Muscle-strengthening activity should also be included twice a week

For a detailed breakdown the British Heart Foundation website.

Similarly, the American College of Sports Medicine (ACSM), in its physical activity guidelines for Americans (2008), outlines:

• Adults should get at least 150 minutes of moderate-intensity exercise per week.

• Exercise recommendations can be met through 30-60 minutes of moderate intensity exercise five days a week, or 20-60 minutes of vigorous-intensity exercise three days a week.

• One continuous session, and multiple shorter sessions (of at least l0 minutes), are both acceptable to accumulate the desired amount of daily exercise.

• Gradual progression of exercise time, frequency and intensity is recommended for best adherence and lowest injury risk.

• People unable to meet these minimums can still benefit from some activity.

So, it is advised to partake in a mixture of moderate and vigorous activity, and the definitions of each can be found below.


Intensity of physical activity

The World Health Organisation (WHO) defines physical activity intensity as 'the rate at which the activity is being performed or the magnitude of the effort required to perform an activity or exercise’. It can be thought of as how hard a person works to do the activity.

The intensity of different forms of physical activity varies depending on the person taking part. This is determined by an individual's previous exercise experience and their relative level of fitness. So, two people cycling on the same straight, flat stretch of road for 20 minutes will work at different levels of intensity. It is useful, therefore, to have a standardised index of activity intensity that can be applied equally to different people and to different types of exercise.

Metabolic equivalent (MET)

Metabolic equivalent (also known as metabolic equivalent task, or MET) is a term used to represent the intensity of exercise by comparing the energy used during activity with the energy used while at rest. One MET is the amount of oxygen you consume and the number of calories you burn (ie, the energy expended) while at rest. So, if you're working at 4 METs, you're working four times harder and expending four times as much energy (consuming four times as much oxygen and burning four times more calories) than you would be while at rest.

MET-minutes are a calculation of the energy expended during activity over a period of time. For example, if you spend 30 minutes jogging at an intensity of 7 METs, the MET-minutes (MET-min) would be calculated as:

7 METs x 30 minutes = 210 MET-min

You can also calculate the MET-minutes per week, by multiplying the MET—minutes for a certain activity by the number of days per week the activity is performed. So, if you jog (as above) for three days of the week, the MET-minutes per week (MET-min-wk) would be calculated as:

210 MET-minutes x 3 days per week = 630 MET-min-wk

Using MET-min and MET-min-wk, you can assess how hard different clients are working across different activities over a period of time. The table below gives examples of a range of different activities.


Source: World Health Organisation

The above table is a guide and you need to remember that individual differences, such as age, will affect whether an activity is deemed moderate or vigorous.

The ACSM offers further classification:

Table adapted from American College of Sports Medicine (2006)

The above table highlights how the classification of ‘moderate’ and ‘vigorous’ can vary considerably when the age variable is added to the equation.

The dose-response relationship

The dose-response relationship, or curve, illustrates that additional health and fitness benefits can be experienced as the amount and intensity of exercise increases, but only up to a certain point; there are other variables that can also affect the outcome.

The greatest health benefits seem to be derived from performing 30-60 minutes of activity per day. Training volumes beyond this give few additional tangible health benefits, although they may give performance benefits to the endurance athlete.

Moderate-intensity physical activity (approximately 3-6 METs)

requires a moderate amount of effort andnoticeably accelerates the heart rate

Vigorous-intensity physical activity

(approximately 6 METs or more)requires a large amount of effort and causesrapid breathing and a substantial increase

in heart rate

Examples of moderate-intensity physical activity include:

• Brisk walking• Dancing• Gardening• Housework and domestic chores• Active involvement in games and sport with

children/walking domestic animals• General building tasks)• Carrying a moderate load (less than 20kg

Examples of vigorous-intensity physical activity include:

• Running• Walking/climbing briskly up a hill• Fast cycling• Aerobics• Fast swimming• Competitive sport and games• Heavy shovelling or digging• Carrying/moving heavy loads (20kg or more)

Intensity Absolute intensity (METs) Absolute intensity (METs) by age

20-39 years 40-64 years 65 and over

Moderate 3.0-5.9 4.8-7.1 4.0-5.9 3.2-4.7

Vigorous 6.0-8.7 7.2-10.1 6.0-8.4 4.8-6.7


The dose-response curve

The ACSM ‘Position stand’ July 2011 states:

‘Several studies have supported a dose-response relationship between chronic physical activity levels and health outcomes, such that greater benefit is associated with higher amounts of physical activity. Data regarding the specific quantity and quality of physical activity for the attainment of the health benefits are less clear.

‘Epidemiologic studies have estimated the volume of physical activity needed to achieve specific health benefits, typically expressed as kilocalories per week (kcal-wk-1), MET-minutes per week (MET-min-wk-l) or MET-hours per week (M ET-h-wk-1). Large prospective cohort studies of diverse populations clearly show that an energy expenditure of approximately 1,000 kcal-wk-1 of moderate-intensity physical activity (or about 150 min-wk-l) is associated with lower rates of CVD [cardiovascular disease] and premature mortality. This is equivalent to an intensity of about 3-5.9 METs (for people weighing 68-91kg) and 10 MET-h-wk-l. Ten MET-hours per week can also be achieved with >20 min-d-1 of vigorous-intensity (2~6 METs) physical activity performed >3 d-wk-1 or for a total of ~75 min-wk-1. Previous investigations have suggested that there may be a dose-response relationship between energy expenditure and depression, but additional study is needed to confirm this possibility.

‘In the general population, this 1,000 kcal-wk-1 volume of physical activity is accumulated through a combination of physical activities and exercise of varying intensities and is recommended as a minimum. Therefore, the 2008 Physical Activity Guidelines for Americans, the 2007 AHA/ACSM recommendations and the ACSM guidelines allow for a combination of moderate- and vigorous-intensity activities to expend the requisite weekly energy expenditure.

An intriguing observation from several studies is that significant risk reductions for CVD disease and premature mortality begin to be observed at volumes below these recommended targets, starting at about one half of the recommended volume (i.e., ~500 kcal-wk-1). For most adults, however, a larger quantity of exercise (2,000kcal wk-1) will result in the greatest health and fitness benefits and may be necessary for promoting and sustaining weight loss.

’The available data supports a dose-response relationship between physical activity and health outcomes, so it is reasonable to state with respect to exercise: "Some is good; more is better". However, the shape of the dose-response curve is less clear, and it is probable that the shape of the curve may differ depending on the health outcome of interest and the baseline level of physical activity of the individual. Performance Training Academy 39

Hea

lth a

nd fi

tnes

s ben

efits

Duration and intensity of physical activity

30 mins a day of moderate activity

60 mins a day of Vigorous activity

More than 60 mins a day, fewadditional benefits, but someincreased risks

‘The physical activity dose required to achieve a specific health benefit may be further clarified by equating specific amounts of physical activity to the levels of cardio-respiratory fitness sufficient to confer health benefits. For instance, a study of apparently healthy middle-aged adults showed that all-cause and CVD mortality rates were approximately 60% lower in persons with moderate compared with low cardio-respiratory fitness, estimated from time to fatigue on a treadmill test.

’The adults of moderate fitness in this study reported a weekly energy expenditure in moderate-intensity physical activity, such as brisk walking on level ground, of ~8-9 MET-h-wk-1. Therefore, a level of cardio-respiratory fitness associated with substantial health benefit seems to be attainable through a dose of exercise or physical activity compatible with the recommendations.’

All clients are different and therefore responses may vary across clients.

Intermittent exercise

One of the most significant - and, at that time, original - messages from the health recommendations issued by the US Department of Health and Human Services (1996) and ACSM (2006) was that health benefits could be gained from several shorter daily sessions of physical activity as well as from the traditional ‘one longer, continuous daily session’ approach to exercise. This recommendation is mirrored by the recommendations of the Chief Medical Officers of the UK (discussed previously).

Performance of intermittent exercise of at least 10 minutes in duration to accumulate the minimum duration recommendations is an effective alternative to continuous exercise (ACSM guidelines for exercise testing and prescription, 8th edition).

It is worth remembering, however, that research in this area is ongoing and therefore personal trainers are advised to always stay up to date with the latest research and recommendations and always seek reliable sources of current guidelines, such as the ACSM and WHO.

Cardiovascular training for fitness

The harder an individual is prepared to train, the greater the fitness benefits they will achieve. This conclusion can be drawn from both general experience and research. In this section, we explore the effects of more vigorous-intensity cardiovascular exercise for improving client fitness and the research that supports this.

Vigorous intensity for most adults corresponds to a heart rate of between 70-80% of their maximum heart rate (MaxHR); this is referred to as the ’performance zone’. The performance zone is also equivalent to 7+kcal per minute, or to 6+METs. Using a 6-20 RPE scale, your client would feel that they were working somewhere between 14-16. Before progressing to vigorous training, it is worth considering all of the potential advantages and disadvantages.


Additional benefits of vigorous training (compared with moderate):

• greater fitness gains

• uses more calories in a shorter workout time

• greater 'after-burn‘ effect once exercise ceases (see exercise post oxygen consumption (EPOC), discussed later in the manual)

• challenging, and therefore more motivating for some clients

Potential barriers to vigorous training:

• greater level of discomfort; this is related to increasing levels of blood lactate (see aerobic threshold, discussed later)

• higher ‘dropout’ rate when compared to moderate-intensity training programmes

• increased injury risk

• increased risk of heart problems in ’at-risk’ individuals (see section on screening, below)

Screening and vigorous physical activity

It is important to screen your clients before participation in any moderate- to vigorous-intensity activities, in order to identify participants with underlying cardiovascular disease, and to appropriately advise or refer them, before they begin exercise. Vigorous physical exertion may trigger ischaemic cardiac events (eg, angina due to lack of oxygen to the myocardium), particularly among people who are not accustomed to regular physical activity and exercise.

The ACSM (2006) suggests the following guidelines:

• It is considered unnecessary for asymptomatic, apparently healthy men and women, irrespective of age or CHD risk factor status, to have a medical evaluation before embarking on a moderate-exercise training programme. For such individuals, pre-participation screening (PAR-O) questionnaires are sufficient.

• Asymptomatic, apparently healthy men under the age of 40 and women under the age of 50 with fewer than two CHD risk factors do not require medical evaluation by a doctor before initiating a programme of vigorous exercise training.

• Men over the age of 40 and women over the age of 50 with two or more CHD risk factors should have a medical evaluation by a doctor before initiating a programme of vigorous exercise training. The referring GP must complete the PARmed-X referral form (see appendix 2 towards the back of this manual, also available from the REPs website: www.exerciseregister.org/).

Adherence to the ACSM guidelines is strongly recommended for those clients who are new to exercise and who wish to participate in vigorous exercise programmes.

Progression from sedentary to vigorous training

The dropout rate from vigorous exercise programmes is estimated at 50% within 3-6 months. Helping clients to remain vigorously active, therefore, is a major challenge for personal trainers. A Performance Training Academy 41

http://www.exerciseregister.org/

further consideration is that the dropout rate significantly increases when individuals are exposed to vigorous activity more frequently (five or more days a week) and for longer durations (more than 45 minutes) (ACSM, 2006).

The ACSM (2006) outlines three stages of progression for improving aerobic fitness: initial, improvement and maintenance.

Source: ACSM guidelines for progression of FITT for a previously sedentary individual (2006)

The initial conditioning stage

The initial conditioning stage usually lasts 4-6 weeks; the exact duration will be dependent on the adaptation of the individual client to their exercise programme. Older adults generally take longer to adapt to exercise training and consequently require a longer initial conditioning stage.

The ACSM suggests that the duration of the exercise session during the initial stage should start at 12-15 minutes and progress to 20 minutes (excluding warm-up and cool-down). Progression in intensity is less important: the focus for the first weeks of a programme should be on developing the exercise habit, rather than setting the standard towards achieving optimal fitness guidelines. The goal is simply getting your client to attend and participate on a regular basis.

The improvement stage

The improvement stage usually starts after around six weeks and lasts four to five months, during which time both the intensity and the duration are increased every two to three weeks until your client is able to exercise at a vigorous intensity for 20-30 minutes. Three sessions per week will achieve sustained improvements; however, if your client can manage four or five sessions per week, then their speed of progression will increase at a corresponding rate.

Programme stage Week Frequency (sessions per week)

Intensity (% MaxHR)

Duration(minutes)

Initial stage 1234

5-6

22333

50-60%50-60%50-60%60-65%60-65%

1214161820

Improvement stage 7-1011-1314-1718-2021-2425-27

33-43-43-43-53-5

65-70%65-70%65-70%70-75%70-75%75-80%

202427303030

Maintenance stage 28+ 3 75-80% 30


The maintenance stage

The maintenance stage usually begins after the first six months of training. During this stage, your client may no longer be interested in further developing and improving their fitness; they may, instead, be content to maintain the fitness levels they have already achieved.

At this stage, it is important to consider reviewing your client's exercise goals and to explore with them various ways of maintaining the enjoyment they get from their exercise programme. One idea is to introduce cross-training into the programme. The frequency of training at this stage can revert back to three times per week. This is acceptable and effective because it is easier simply to maintain a level of fitness than it is to initially make improvements to fitness.

Another example is a pregnant female client who is used to exercise focusing more on maintaining than on improving her current level of fitness. As her pregnancy progresses, she may need to reduce rather than increase her level of training. A pregnant woman who is unused to exercise should always check with her GP before becoming more active. She would be better advised to follow the guidelines to improve cardiovascular fitness for health, rather than for fitness.

Aerobic threshold

The majority of the energy required for low-intensity exercise can be supplied by aerobic metabolism. As intensity increases, energy production is gradually supplemented more and more by anaerobic metabolism. This results in lactic acid being produced in the muscles, which must be dispersed in the blood. The higher the level of lactic acid in the blood, the more uncomfortable the participant will feel. Blood lactic acid (lactate) is measured in mmol/l.

The graph below shows how lactic acid levels typically rise with increasing exercise intensity. Notice that there is not a linear relationship; instead, the line quickly becomes steeper as the intensity increases.

- - - - - - - - - - - - - - -

Exercise physiologists have found that distinct blood lactate thresholds exist. If you know your client's threshold, you can use it to make their training more effective. The best known of these is the ’lactate threshold’, or ‘anaerobic threshold’ (this is covered further on in the manual). More relevant for this section is the less familiar ‘aerobic threshold’. This is generally accepted as occurring when blood lactate concentration reaches about 2mmol/l. Performance Training Academy 43

40% 50% 60% 70% 80% 90% 100%

0

1

2

3

4

56

7

8

9

10

Aerobic threshold

Lactate curve

Bloo

d la

ctat

e (m

mol

/l)

Exercise intensity (%MaxHR)

The aerobic threshold is significant for the following reasons:

• Up to the aerobic threshold, lactate levels are not high enough to cause much discomfort. Beyond the threshold, lactate levels increase quickly and discomfort becomes more obvious. This correlates closely with the change from moderate- to vigorous-intensity exercise.

• Specific adaptations to the cardiovascular system are initiated at this level. Aerobic enzymes within the mitochondria seem to respond best to training above aerobic threshold, as does the efficiency of slow oxidative muscle fibres.

• Up to the aerobic threshold, the majority of energy for exercise is supplied from fat. Beyond this threshold, carbohydrate begins to contribute increasingly to the energy required. This is partly because high blood lactate levels inhibit the body's use of fat for energy.

• Experience suggests that very long distance races such as marathons are completed by competitors running at blood lactate levels close to 2mmol/l. This may be related to the efficient use of fat and the sparing of precious glycogen stores.

The best way to establish an individual’s aerobic threshold is to take regular blood lactate samples during a controlled incremental exercise session. Small handheld testers are relatively inexpensive and simple to use, provided your client doesn't mind having blood samples taken by a small thumb prick.

Alternatively, the aerobic threshold can be estimated by performing a graduated exercise session and identifying when an RPE of 14 (on a 6-20 scale) is reached.

Cardiovascular training for performance

Improving performance is likely to be a goal for a client who has already achieved general fitness and who would naturally include exercise as a regular part of their life. This type of client may choose to train for a particular sport or event (eg, a 10km run), will enjoy the challenge of hard training and will more readily accept the discomfort and increased risk of injuries from more intense training.

This section looks at things to think about when designing a cardiovascular training programme for well- trained and more competitive clients. In these cases, the most useful piece of information is to establish their onset of blood lactate accumulation.

Onset of blood lactate accumulation (OBLA)

Previous sections discussed the concept that as intensity increases, aerobic energy production is gradually supplemented more and more by anaerobic metabolism, and this means that lactic acid is produced in the muscles and must be dispersed in the blood. The aerobic threshold occurs when blood lactate reaches approximately 2mmol/l, and the participant begins to feel more discomfort.

If an individual continues to increase the intensity of their workout, they will eventually reach a point where they will produce more lactate than their body can disperse or remove, so the acid accumulates in their blood. This ultimately causes so much discomfort that they have to either slow down or stop.


The point at which lactate accumulation exceeds the rate of removal by the body is referred to as the ‘onset of blood lactate accumulation’ (OBLA), or as it is more commonly known, the ‘anaerobic threshold’. The anaerobic threshold represents the uppermost limit of aerobic performance; it is an individual’s maximum sustainable pace without suffering the performance-slowing effects of acidosis - when someone has too much acid in their body fluids. OBLA is widely identified by exercise physiologists as the work rate (Watts, running speed or % VO2 max), at which blood lactate reaches 4mmol/l.

OBLA typically occurs somewhere between 80-90% MaxHR for someone who is moderately or very fit. For someone who is less fit OBLA can occur as low as 70% MaxHR.

- - - - - - - - - - - - - - -

The graph above shows the correlation between lactate and increasing intensity. OBLA occurs at approximately 4mmol/l.

Practical application and uses of OBLA

There are four main benefits to knowing about OBLA:

• Training at or slightly above OBLA is the most effective way to develop aerobic fitness (Weltman, 1995 provides a complete summary of research to support this) .

• OBLA is found to increase rather more rapidly than VO2 max and to go on increasing as intensive aerobic training progresses. In this respect, it is a more useful indicator of performance than VO2 max.

• Using blood lactate reference points came about because it was observed that optimal times in 5- 10km running events require performing close to OBLA.

• Specific adaptations to the cardiovascular system are initiated at this level, including:

• increased tolerance to lactic acid

• improved ability both to oxidise and remove lactate

• increased oxidative capacity of the fast oxidative glycolytic (FOG) muscle fibres.

However, there is also considerable disagreement about the 4mmol value. Stegman et al (1981) found that the threshold at which blood lactate begins to rise varies considerably between individuals, from around 2mmol-7mmol. The implication of this is that the training efficiency of Performance Training Academy 45

Anaerobic threshold (OBLA)

Lactate curve

40% 50% 60% 70% 80% 90% 100%

0

1

2

3

4

5

67

8

9

10

Bloo

d la

ctat

e (m

mol

/l)

Exercise intensity (%MaxHR)

many elite athletes, having been assigned training paces based upon the 4mmol work intensity, will vary significantly; some will have overtrained, some will have overloaded appropriately, and some will have undertrained.

While there is considerable variation among individuals, OBLA values are still generally accepted as good predictors of endurance performance and represent useful benchmarks for evaluating training progress.

Estimating OBLA

The only truly accurate way of measuring blood lactate levels and establishing OBLA is via continuous blood sampling. However, this is neither practical nor pleasant for clients. A reasonable estimate of OBLA can be made as follows:

• Stegman and Kindermann (1982) proposed a concept termed ‘individual anaerobic threshold’, or ’maximal steady state‘. This refers to the highest intensity output that can just be maintained for 15-20 minutes without a continual increase in blood lactate accumulation. A monitor is used to record heart rate throughout the duration of the test. The average heart rate then gives a reasonable indication of OBLA.

• An alternative approach for determining the blood lactate response to exercise is to use the RPE 6-20 scale. A large number of studies have shown a strong relationship between RPE and the blood lactate response to exercise. This is a relationship that does not appear to be affected by gender, training state, type of exercise or intensity of training (Boutcher et al, 1989; Demello et al, 1987; Dishman, 1994; Haskvitz et al, 1992; Hetzler et al, 1991; Seip et al, 1991; Steed et al, 1994). The perceived exertion at OBLA does not change with training despite the fact that aerobic threshold and OBLA occur at higher intensity outputs. A blood lactate concentration of 4mmol corresponds closely to a rating of perceived exertion (RPE) of between 16-17 (Weltman, 1995).

Anaerobic training

Anaerobic adaptations occur when training intensity is at or above OBLA. For people who are moderately or very fit, this generally equates to a heart rate of 80/90-100% of MaxHR. For people who are less fit, anaerobic training will occur at a significantly lower MaxHR.

Working at this level of intensity is very demanding and can only be done in short bursts lasting a few seconds. interval training is often used for this purpose. The adaptations to anaerobic training are specific to the energy systems and muscle fibres employed, and they include:

• improved nervous system recruitment of fast glycolytic muscle fibres

• increased levels of anaerobic enzymes within the muscle fibres

• increased tolerance of large amounts of lactic acid in the muscles

• faster muscular contraction speed, leading to improved sprinting ability

When structuring anaerobic training sessions into a weekly training schedule, sufficient time must be allowed for the muscles to recover. Working at these higher intensity levels increases delayed onset muscle soreness (DOMS), and a minimum of 48 hours should pass before those specific muscles are targeted again. Immediately after these more intense sessions, the client should be Performance Training Academy 46

instructed to cool down effectively and thoroughly stretch all the major muscles used in the workout.

Overtraining

The formula for success (hard training) may equally be a formula for athletic demise. The boundary between hard training and overtraining is far from clear and tolerance to different training schedules is very much determined by the individual. There are certain common factors that have been identified by some researchers; Lehman et al (1998) state that the risk of overtraining is increased by:

• inadequate recovery between training sessions

• one-sided, monotonous training without altering hard and easy days

• a lack of one complete rest day per week

• excessive amounts of high-intensity training

• too many competitions

• significant other non-training stresses, eg, work, lifestyle, family commitments, etc.

In their review of the physiological responses to overtraining in endurance athletes, these researchers found that the maximum sustainable programme was about three weeks of intensified or prolonged endurance training of more than 3 hours per day.

The symptoms of overtraining

The symptoms of overtraining are numerous and may change according to the length of time the individual has experienced that state. Initially, the nervous system may go into ‘overdrive’ in response to trying to cope with the intolerable demands. Symptoms may include:

• fatigue

• higher than expected heart rate both at rest and during exercise

• sleep problems (nightmares, waking often during night)

• elevated blood pressure

• emotional instability, poor concentration and inability to relax

• reduced training performance and delayed recovery after training

• increased number of injuries

Recovery from this initial overtrained state can be fairly quick (measured in days/weeks) if the individual is prepared to take some time off to recover. If the individual ignores how their body is reacting and continues to train excessively then their nervous system reaches a ‘depletion’ stage, symptoms may change to include:

• excessive sleeping and chronic fatigue unrelieved by bed rest

• lower than expected heart rate both at rest and during exercise


• depressed feelings and loss of competitive drive

• severely reduced training performance

• low blood pressure

• impaired immune function; the obvious consequence here is vulnerability to bacterial and viral infections (Mackinnon, 1992; Shephard and colleagues, 1991)

This is a much more serious condition and may take many weeks or even months of complete rest to fully recover.

The bottom-line advice for avoiding an overtrained state and maximising training gains is for the client to listen to their body. As a personal trainer, it is essential that you plan your client's training programme carefully, remembering that sufficient recovery time is equally as important for improving fitness as the training programme itself.

Periodised training - where different aspects of training are organised into phases throughout a specific training period (eg, a year) in order to maximise the individual's development - naturally takes into account the need for appropriate resting time. This type of programme varies the workload on a cyclical basis and builds in recovery phases after the most intense phases of training.

Cardiovascular training and controlling body fat

Weight management and fat loss is a common goal. One of the questions clients starting exercise most frequently ask is: 'What is the best way to burn body fat?’ There are many myths and half-truths rife in the fitness industry on the subject of weight loss and management.

This section reviews the health risks associated with excess body fat and explores training methods and approaches for working with clients who wish to manage their weight and control body fat.

Health risks associated with excessive body fat

Many adults in the UK are either overweight or obese. in fact, according to a 2011 Health and Social Care Information Centre survey, 61 .5% of people in England aged 16 and over were oven/veight or obese, with around a quarter of those classed as obese.

Some people want to lose weight for cosmetic reasons - a desire to look better, to feel more confident, to improve body image or possibly to achieve a body like the stereotypical ‘ideal’ that fills the media. Others may wish to lose weight to improve their health.

Obesity is closely linked with a number of other chronic diseases. The UK government identifies the top four health risks associated with obesity as:

1. high blood pressure (hypertension) 2. coronary heart disease (CHD) 3. type 2 (adult onset) diabetes 4. osteoarthritis


These are all serious and debilitating conditions that reduce a person's quality of life and also place avoidable demands on the NHS. In financial terms, it is estimated that obesity costs as of 2013 are estimated at around £51 billion per year.

The rapid increase in the number of obese people in the UK is a major challenge. Analysis by the government's Foresight programme suggests that more than half of the UK adult population could be obese by 2050. The economic implications are substantial, too. it is estimated that obesity and weight- related problems will cost the NHS £10 billion per year by 2050, by which time the wider cost to society and the economy is projected to have reached £49.9 billion per year (at today's prices) (McCormack and Stone, 2007).

Obesity is also a risk factor for other health issues, including reduced immune function (which, in turn, increases a person's chance of getting infections); snoring and difficulty breathing while asleep; gallstones; varicose veins; low self-esteem and reduced capacity for activity and exercise. Being obese also makes it harder to climb stairs or stand up from a chair, and to get into and out of a bath, and can cause problems during surgery (it makes it more difficult for surgeons to operate as layers of body fat get in the way).

Negative energy balance

The only effective way to reduce weight and lose body fat is to eat fewer calories by and/or expend more calories by becoming more active. This creates what is known as a negative energy balance - when you burn more calories than you consume. Energy balance was discussed at Level 2.

Any weight-loss programme that does not create a negative energy balance will not work. Incidentally, weight-gain programmes (such as that of a bodybuilder in a bulking-up phase) must create a positive energy balance or they will be unsuccessful, too.

The energy input side - food, diet and nutrition - should ideally be dealt with by a nutritionist. The focus for you, as a personal trainer, should be on the various factors that affect energy output - exercise intensity, duration and frequency - with the aim of developing a sensible regime for your client to lose body fat at an appropriate rate.

Exercise intensity and fat utilisation

This is an area of long-standing controversy. Often, people are advised that the best way to burn fat is to exercise at a low intensity for a longer duration. Cardiovascular machine manufacturers also often recommend the so-called ’fat burning’ zone of low intensity (usually around 60-70% MaxHR, which is the equivalent of a brisk walk for most people) as being the most effective programme for weight loss.

This approach to fat burning is based on the fact that at a low intensity, the majority of energy burnt will be supplied by fat rather than glycogen (stored carbohydrate). If the intensity is taken higher (eg, a run), then more of the energy will come from glycogen, and therefore the body is no longer ’fat burning’. There is some truth in this, but it fails to take into account the total energy expenditure, which is another important factor in fat burning and weight-loss programmes.


Fat is our largest store of energy. It is a fuel tank that is distributed throughout the body, stored both around the vital organs and as adipose (fatty) tissue. Fat is being used all the time as the energy source for normal metabolic functions, such as breathing, digesting food and keeping warm, regardless of whether any exercise is being done. In this respect, anything we do could be termed ’fat burning’. Sleeping or sitting watching television are both ’fat burning’, and in fact, both would burn a very high proportion of fat compared to glycogen.

If sleeping or watching television both burn fat, it calls into question why so many people are overweight. The answer, in fact, relates to the total energy expenditure (or calories burnt).

The graph above shows energy expenditure and fat utilisation with increasing intensity (adapted from Romjin et al, 1993).

When inactive (seated), the total energy expenditure is so low that it is ineffective for fat loss, regardless of the fact that most of the energy used comes from fat. When performing light activities, only slightly more energy is used, with a higher proportion of that still coming from fat sources.

The most significant change occurs during moderate activity. The total energy used to perform moderate-intensity activities almost doubles (when compared with low-intensity activities) and more than half of this energy comes from fat stores.

Vigorous activity, for the same duration, yields another significant increase in the total energy expenditure, and the proportion of glycogen and fat used to fuel energy also increases as the activity intensity increases. However, the actual amount of fat used is close to that for moderate-intensity activity.


0

Intensity

No activitye.g, seated

Light activitye.g, housework

Moderate activitye.g, a brisk walk

Vigorous activitye.g, a hard run

Fat

Glycogen

Kca

l use

d

50

100

150

200

250

300

350

The key message is that exercise at high intensity can achieve fat loss just as well as exercise at moderate intensity. This begs the question: ’Why should someone bother to work at a higher intensity if it burns about the same amount of fat as working at a moderate intensity?’ And how can you ’sell' the idea of working at a higher intensity to a reluctant client?

There are several reasons, or selling points:

• The energy supplied by glycogen in high-intensity exercise is still important to fat burning. This energy has to be replaced somehow. This will either be from the carbohydrates in your client's next meal (so they can eat more carbohydrate without it being stored as more fat), or from gluconeogenesis (the manufacturing of carbohydrate in the liver), which is itself an energy-consuming, and therefore calorie- burning, process.

• Your client will gain in increased fitness.

• High-intensity exercise will provide increased cardio-protective benefits - ie, it is better for the heart.

• It will result in increased excess post-exercise oxygen consumption (EPOC), which is explained further in this section.

• It will take less time to burn the same amount of energy or calories.

The only reasons to continue to advocate low-intensity activity and exercise for fat burning is if the client has a low fitness level and low-intensity exercise is the only type of activity that would be safe for them.

Unfortunately, the research findings discussed earlier suggest that many adults fall into this category. For a lot of clients, low-intensity training is their only option and the only way they will stick to an exercise programme to begin with. However, there is no reason why these individuals cannot gradually increase the intensity they work at over time, following the ACSM guidelines, to gain additional benefits.


Exercise duration and fat utilisation

Another commonly held but false belief within the fitness industry is that fat burning only begins after 20~ 30 minutes of continuous exercise.

It is true that at the start of a training session a higher contribution of total energy (calories burnt) will come from carbohydrate (stored glycogen and glucose in the blood) and that as the duration of the session increases, there will be a gradual shift in the contribution from carbohydrate to fat (see the graph below). This appears to be because the mobilisation, transport and use of fat in the muscles all take more time to begin working efficiently.

The graph above appears to show that fat burning does not start until 20-30 minutes into the workout, but what this actually illustrates is simply where the crossover point is and at what point you start to burn greater than 50% fat. It does not mean that no fat will be burnt earlier in the session, but it will be proportionately less.

Interestingly, for a trained individual (eg, an endurance athlete), the crossover point — where the participant gets more energy from fat than from carbohydrate — will be sooner. A trained client may also burn a higher proportion of fat at rest compared with someone less fit because of the long-term physiological adaptations that have taken place.

Long-term physiological adaptations to training that improve fat-burning potential include:

• more mitochondria

• better fat transport in the blood

• more fat-mobilising enzymes in adipose (fatty) tissue

This is another example of how the fitness level of the client contributes to successful fat loss. Duration of exercise is important for fat loss but this is mainly because it affects the total energy expended and not because of the proportion of fat used.


Minutes of walking

Perc

enta

ge o

f fue

l sup

ply

0 20 40 60 80 100 120

20

0

40

60

80

100Carbohydrate

Fat

The combination of exercise duration and frequency

Frequency and duration of exercise combined are the most important factors for achieving fat loss. The aim of any fat-loss programme is to expend as much energy as possible and this can be achieved by exercising more frequently and for longer. It is simply a matter of basic mathematics: walking briskly for 30 minutes three times a week will burn around 600kcals; walking briskly for 45 minutes five times a week will burn around 1,500kcals. (The actual number of kilocalories burnt would vary according to body weight and stride efficiency, etc.)

Using the first training approach, it would take about 13 weeks to burn off 1kg of body fat (requiring approximately 7,700kcal to be expended). The second approach would take closer to five weeks. Thus, more frequent activity offers more potential for more effective weight loss.

As with all training programmes, realistic time management and the possibility of overtraining need to be considered.

Excess post-exercise oxygen consumption (EPOC)

EPOC refers to the period after exercise has finished when the metabolism is still raised above normal resting levels (and is still burning calories). It is commonly referred to as the ’after-burn effect’ or ‘after- glow’. The reason for elevated metabolism after exercise is not fully understood but is thought to be due to the body replenishing creatine phosphate and glycogen stores, resaturating red blood cells with oxygen and oxidising lactate that has built up during the training.

All these processes are energy-consuming and fuelled using fat as the main energy source. If a significant EPOC can be stimulated through exercise, then calorie usage and fat burning will continue long after the client has finished training when they are back in the office or relaxing at home, for example.

Findings from research into the relationship between EPOC and the intensity of exercise vary. Bahr and Sejersted (1992) showed a clear relationship between the duration of EPOC and the intensity of the exercise session performed. Their study involved three groups, each cycling for 80 minutes, but at different intensities. They found that at a light intensity there was a negligible ‘after-burn’ effect. However, with moderate and vigorous intensities, they found a markedly longer duration of raised metabolism (EPOC). In both the moderate and vigorous groups, the EPOC was greatest within the first one to two hours after exercise and then quickly tailed off, becoming much less significant as the hours passed.

Duration of EPOC for three different cycling intensities:

Source: Bahr and Sejersted (1992)

Exercise intensity Appropriate MaxHR Duration of EPOC

Light (29% VO2 max) 45% 0.3 hours

Moderate (50% VO2 max) 65% 3.3 HOURS

Vigorous (75% VO2 max) 80% 10.5 hours


While it should be recognised that not all studies in this area have revealed the same degree of difference as these researchers, there is still a general consensus that the EPOC period is longer with higher exercise intensity. A threshold level of about 70% MaxHR appears to be most appropriate to create any significant ‘after-burn’ effect.

Exercise modality

Modality refers to the type of exercise undertaken, such as jogging, swimming, cycling, step aerobics, etc. Some studies have been published that infer a specific type of programme is more effective than another type for energy expenditure. There is no specific consensus for one modality being more appropriate than another. The primary consideration is that if the total energy expenditure is the same, any cardiovascular exercise mode will have a similar effect. The priority should be to select an exercise modality (or variety of modalities, eg, cross-training) that your client enjoys, can participate in easily and find motivating and ultimately, that they will adhere to for longer.

A further consideration is that clients who are heavily overweight or obese may initially find non-weight-bearing exercises, such as swimming, aqua aerobics, stationary cycling or stationary rowing, much more comfortable, easier to perform and far less stressful on their joints than weight-bearing and higher impact exercises, such as jogging, jumping and running.

Resting metabolic rate

A large part of our daily calorie expenditure (and therefore fat burning) has nothing to do with activity. Calorie expenditure is needed to fuel our resting metabolism, which includes body processes, such as:

• breathing

• circulation

• keeping warm

• chemical reactions

• brain function

• normal maintenance of body tissues

The higher the resting metabolic rate (RMR), the more calories will be burnt, regardless of how active the individual is. There is an argument that RMR is genetic: some people are born with a high RMR and that is why they remain lean, while others are born with a low RMR and that is the main reason they gain weight. However, most well-controlled studies have failed to show any significant difference between the metabolisms of slim and overweight people. There is strong evidence to suggest that levels of spontaneous activity, rather than metabolism, may well be genetically influenced.

One factor that definitely does affect RMR, and that it is possible to change, is lean body mass. A lean 100kg person will need roughly twice as many calories as a lean 50kg person, merely to fuel their RMR and survive from day to day. Any increase in lean tissue (muscle) a person can achieve will have a significant effect on creating a negative energy balance, and therefore improve long—term control of body fat.


Cardiovascular exercise will help to maintain and even build lean tissue to some extent, but not as effectively as a well-planned resistance-training programme aimed at strengthening the major muscles. This implies that resistance training to help build and maintain lean tissue should be an important part of any fat-loss programme.

The following summarises and reinforces the key points covered in this section:

1. Fat can be burnt at any exercise intensity. Low-intensity exercise is most appropriate if your client's fitness level is low, in order to encourage them to stick to the programme.

2. Total energy expenditure (kilocalories) is the most important factor in fat loss. The percentage of fat compared with carbohydrate being used is less significant.

3. You should emphasise cardiovascular fitness as the primary goal for the client, rather than merely fat burning. The greater the cardiovascular fitness, the greater the potential for fat burning.

4. Frequency and duration of exercise are vital: the longer and more often you work out, the better.

5. The modality of cardiovascular exercise performed is not important. It should be something that the client is likely to enjoy and adhere to and is appropriate to their needs (body type, fitness, health status, etc.).

6. EPOC may contribute significantly to calorie expenditure. EPOC appears to be greater for higher- intensity exercise sessions. A threshold level of about 70% MaxHR is necessary to create any significant effect.

7. RMR also contributes significantly to calorie expenditure. Resistance training for the major muscle groups is the best way to increase RMR.

Finally, and most importantly, fat loss involves creating a ‘negative energy balance’. in this section‘, we have focused attention primarily on activity and exercise (energy output). However, if a client continually eats more than their body needs (thereby putting in too much energy), then little progress will be made.


Cardiovascular Training Approaches

Through each of the previous sections, we have explored different training goals (health, fitness, weight loss, performance, etc.) and the training effects obtained by exercising at various intensities.

This section explores the four training zones and some practical approaches to cardiovascular training to achieve the different goals that each client may present. it also looks at the RPE and ‘how it feels’ scales for monitoring exercise intensity.

The four cardiovascular training zones are illustrated below:

The exact heart rate at which the transition from one zone to another occurs will vary between clients (some individual factors that affect training potential are revised later).

The onset of blood lactate accumulation (OBLA) will not always occur at the same percentage MaxHR for everyone; if your client is unfit, then it will probably occur at a much lower level of intensity. It is important to monitor clients closely using appropriate methods (eg, the RPE scale, discussed later in this section) and to obtain regular visual and verbal feedback. It is wise not to rely on heart rate percentages alone until you have some experience of training your client and are familiar with how their heart r ate responds to exercise.

The specific adaptations in the body in response to cardiovascular training will depend on which of the four zones you use. The percentage heart rates for the four zones may also vary slightly depending on the client.

The following table summarises some of those adaptations:


50%

70%

80%

90%

100%

20 30 40 50 60 70

Low to moderate zone(55-70%)

Aerobic Zone(70-80%)

Anaerobic Zone(80-90%)

Peak Performance Zone(90-100%)

Age

% M

ax H

R

Findings of research into effective maximum heart rate training zones are constantly changing and, with this in mind, you need to ensure you stay up to date with the most current information, using reputable sources, such as the ACSM.

Monitoring intensity

Monitoring the intensity of the workout is essential to ensure clients are working at the appropriate level to achieve their goals. There are many ways to monitor exercise intensity. These include:

• observation of visual signs (skin colour, technique, etc.)

• talk test (monitoring breathlessness, etc.)

• heart rate monitoring

• rating of perceived exertion (RPE) and ‘how it feels’ scales

Each of these methods is covered in the Level 2 ‘Principles of exercise, health and fitness’ unit, which can be found in the Level 2 manual.

Cardiovascular training approaches and intensity levels

The three basic cardiovascular training approaches include

1. continuous 2. interval 3. fartlek

Zone % MaxHR Physiological Adaptions

Moderate 50-60% • Increases utilisation of fat as fuel• Increases number and size of mitochondria• Increases muscle capillary density

Fitness 60-70% • Improves slow twitch, type 1, muscle fibre recruitment• Increases aerobic enzymes• Improves oxygen transportation• Increases efficiency of glycogen utilisation (aerobic glycolysis)

Performance 70-80% • Introduces fast twitch, type 2, muscle fibre recruitment• Increases efficiency of glycogen utilisation (anaerobic glycolysis)• Improves clearance of lactic acid• Increases anaerobic threshold

Performance (Anaerobic)

80-90% • Improves fast twitch, type 2, muscle fibre recruitment• Increases anaerobic enzymes• Increases VO2 Max


At Level 3. there are several variations that develop the themes of each of the above basic training methods. Personal practice of each of method will help you to evaluate the suitability of each of the following approaches for working with different clients and their different training goals.

You should familiarise yourself with the method by trying it for yourself to gauge how appropriate it is for different fitness levels and specific groups. An understanding of specific client needs and effective use of monitoring intensity, as well as gathering feedback, will also help you to select appropriate methods. For example, more intense and vigorous programmes would be inappropriate for specialist groups.

Moderate zone training (continuous)

These are sometimes referred to as ‘easy workouts’. The client should not exceed an intensity of 70% MaxH R, or RPE of 14, but on average they should stay between 50~60% MaxHR. Moderate zone workouts should feel easy both physically and psychologically.

Easy workouts emphasise duration rather than intensity. They might be used as a starting point for a beginner or by a moderately fit client wishing to extend how long they can run, swim or cycle, for example.They can also be used by very fit athletes in a recovery phase in the weeks following an intense competition. They are generally about 20-60 minutes in duration.

The main problem with this type of training is that people become bored, knowing that they are capable of much higher intensities, and are tempted to push too hard. A heart rate monitor can be useful to help maintain an easy pace.

Long slow distance training (continuous)

The difference between long slow distance training (LSDT) and easy workouts is the length of the training session. The average duration for LSDT is about two to five hours. Because of the time commitment involved, they will most likely be used by a dedicated athlete or a client with a very specific performance goal, such as running a marathon or competing in a triathlon.

The main aim of LSDT is to improve endurance potential. The key adaptation that occurs with this type of training is an improvement in fat metabolism. The body becomes more efficient in releasing and using free fatty acids due to changes in different enzymes and hormones in the body. LSDT also develops the psychological skill of discipline and maintaining pace.

Preferred exertion training (continuous)

The most common problem in prescribing exercise intensity is the error that occurs when exercise intensity is calculated from a training heart rate range based on an age-predicted maximum. Preferred exertion offers an alternative approach to exercise prescription that is far less technical and potentially more useful in determining an appropriate level of exercise intensity for a continuous cardiovascular workout.

There is some evidence to suggest that gains in physical fitness can be greater when the exercise intensity is based upon 'perceived' exertion as opposed to heart rate (Koltyn and Morgan, 1992). Research conducted by Dishman et al (1994a) suggests that both active people and those with a sedentary lifestyle prefer to exercise at an intensity of around 70% of MaxHR (60-65% of VO2 max), Performance Training Academy 58

regardless of their activity history. In this study, 11 highly active and 12 not very active males (aged 18-31 years) participated in two exercise sessions on an electronically braked bike. The first session was a continuous incremental maximal test to assess RPE and various metabolic measures while cycling. The second session focused on asking the subjects to cycle continuously for 20 minutes at their preferred exercise intensities.

The not very active male subjects maintained a near-constant power output throughout the exercise session, while the highly active subjects employed a warm-up strategy. The significant point was that both groups’ preferred power outputs were in the 11-14 RPE range, which represents 60-70% of MaxHR (50- 60% of VO2 max).

The clear message that emerged from this study was that preferred exertion can be just as effective as heart rate zone for setting exercise intensity. In fact, it may be a more effective method for people who lead sedentary lifestyles, because of the potential for better long-term adherence. Dishman (1994b), in a study that reviewed exercise prescription procedures for healthy adults, concluded that a preferred intensity of exercise may be better to promote adherence than a strict prescription based on more precise physiological criteria, especially if those criteria conflict with a person's intensity preference.

This view is further supported by an observation made during a one—year randomised clinical community exercise trial (King et al, 1991). In this study, 357 middle-aged inactive adults were assigned to either a low- or high-intensity group. Over the year, similar adherence levels were observed for both groups, but it was noted by the researchers that, over the course of the year, both groups selected intensities that gradually regressed towards a common intensity level of 11.7-13.1 RPE.

To use the concept of preferred exertion, you would simply ask your client to select a pace that they could comfortably maintain for 20 minutes or more, rather than setting a specific heart rate level to be achieved. Generally, the client will choose to exercise at a level corresponding to an RPE of 12-14.

The following graph highlights the preferred exertion/continuous training typical RPE representation.


10

12

14

16

RPE

Preferred exertion/continuous

Tempo training (race pace)

The aim of tempo training is to perform a continuous workout, keeping to a maximum sustainable pace for 20-60 minutes. The intensity will be just below OBLA.

Tempo training is also referred to as ‘threshold’ training or ‘race pace’ training, because it closely simulates the pace at which a competitive 5km or 10km distance would be run. The main challenge with these sessions is to correctly judge and hold the maximum pace despite the discomfort associated with high levels of lactic acid in the blood.

The following graph highlights tempo training at a constant pace just below OBLA.

Tempo training sessions can also be used as performance markers. For instance, in a 5km run, the finish time could be used to:

• Provide a benchmark for measuring future performance

• Analyse the pace maintained

• Estimate current fitness level

• Create future targets


OBLA

Tempo training

Fartlek training

The word ‘fartlek’ means ‘speed play’ in Swedish. This style of training evolved from outdoor running. where athletes would naturally vary their pace according to the terrain and how they felt. Many Styles of fartlek exist and it has been applied to various other CV modalities as well as to running. The essence Of the training remains the same: a constantly varying pace.

When using cardiovascular machines, the ’random' programme is normally selected to simulate fartlek training; the workout is set from the many thousands of different random courses in the console s memory.

However, fartlek training can be easily simulated using manual operation and changing pace/levels 35 and when desired, using the console’s operation controls. This approach more closely resembles true fartlek training, because the client can control the pace according to how they feel.

The following graph is an example of a fartlek cardiovascular workout

Fartlek training adds variety to a workout and trains the different energy systems and muscle fibre types. Training in response to ‘how they feel’ will be empowering to some clients, as it offers them a sense of control, which may enhance their enjoyment of the session.

The planning process for a fartlek workout is less structured than for other training systems because so much depends on the feedback you receive from your client throughout the duration of the training session. However, certain parameters can be estimated in advance, including:

• the overall duration of the session

• how hard the overall workout will be, and which energy system(s) will be prioritised (eg, will it be entirely aerobic, or will there be some time spent above OBLA?)

• the minimum and maximum intensities that your client will use (eg, will peaking sprints be included to target the creatine phosphate energy system, or will this be too demanding for the client?)

• the factors that can be manipulated in order to vary the stimulus on the body. For example:

• treadmill - speed and incline


Fartlek CV workout

Trainingzone

Pulseraiser

Main CVworkout

Pulselowerer

• cycle - pedal speed, resistance level and cycling position (seated or standing for a hill climb)

• cross-trainer - speed and resistance level

• rower - SPM and resistance

• outdoor walking and running - distance, pace, hills, etc.


Interval training

Interval training methods are popular because they use repeated bouts of high-intensity training with regular and well-timed rest intervals. This allows for recovery and removal of lactic acid so that discomfort always remains manageable.

Psychologically, intervals provide short-term goals within the overall training session; clients are often prepared to train at a higher-work intensity than usual because they know that a recovery period is coming up soon. Also, from a planning and progression perspective, intensities and work-to-rest ratios can be applied systematically to target the desired energy systems and muscle fibre types.

The following table shows general guidelines for interval training:

Aerobic intervals

Interval training can be used with clients who are unfit, provided that the intensity and work-to-rest ratios are appropriate. Easy intervals could consist of one-minute training at a moderate intensity (13 RPE), followed by one-minute rest at easy level (11 RPE), repeated 10 times (or as appropriate to the individual client's needs).

Varying the intensity in this way makes the overall workout easier than a continuous 'moderate zone’ session. It also sets a series of psychological mini goals for the client to achieve within the session.

Aerobic intervals are an ideal way to progress intensity of training into the fitness zone and are appropriate for a moderately fit client. A training session might consist of two-minute work intervals at a hard level (16 RPE) and two-minute rest intervals at a moderate level (14 RPE). The work interval challenges the client, but remains within the capacity of their aerobic energy system.

Progression is achieved by gradually increasing the duration of the work intervals over a number of weeks, until eventually a continuous training intensity of about 80% MaxHR (16 RPE) can be sustained.

General guidelines for interval training (Lamb, 1984)

Major energy system

Approximate exercise duration (mins/secs)

% intensity Work-to-rest ratio Number of intervals

PC 0.100.20

100100

1:31:3

20-3010-20

PC - LA 0.300.40-0.50

100100

1:31:3

8-188-16

LA 1.001.10-1.301.30-3.00

95-10095-10090-100

1:21:21:1

5-155-124-10

LA-Aerobic 3.00-4.004.00-5.00

80-9070-90

1:11:0.5

3-83-8


Aerobic intervals are also useful when working with clients who are interested in controlling their body fat. The higher-intensity intervals will use up more kilocalories and will stimulate a greater EPOC, while the lower-intensity intervals allow recovery and an increased overall duration to be achieved.

The following graph shows aerobic intervals working within the fitness to performance zones:

Cruise intervals (lactic acid system)

Cruise intervals consist of performing repeated intervals slightly above OBLA for three to five minutes each, broken up by recovery periods of a similar or slightly shorter duration (ie, a work-recovery ratio of 1:1 or 1:2).

Cruise intervals are an excellent way to raise OBLA. The work periods force the client to tolerate higher levels of blood lactic acid than they would normally experience at a constant pace, but only for a few minutes. This provides them with the overload necessary to stimulate adaptations in their body. The rest periods allow for some of that lactic acid to disperse, which enables the client to recover just before the next work period begins.

The graph above shows cruise intervals - working just above OBLA.


Aerobic intervals

Max

HR

Pulseraiser

Main CVworkout

Pulselowerer

80%

70%

OBLA

Cruise intervals

Pulseraiser

Main CVworkout

Pulselowerer

Negative splits

The aim of a negative split training session is to complete the second portion of each work interval at a faster pace than the first portion. The interval is often split halfway through, but this is not essential. The faster pace could kick in three quarters of the way through an interval or even later.

Negative split training gets the participant used to changing pace and is particularly suited to a client who is preparing for a middle distance event where competitors naturally speed up as the race nears the finish.

Ladders

A ladder programme consists of intervals that become progressively quicker without recovery. It is similar to the pyramid approach used in resistance training.

For example, on a treadmill, the ladder could be:

• two minutes at l2kph

• two minutes at 13kph

• two minutes at 14kph

The ladder would continue until the client reaches a pace that can no longer be maintained. They would then slow down for several minutes of active recovery before beginning the ladder again for a second time.

A ladder is a tough and very intense method of training suitable for competitive clients. The workout covers a variety of intensities and pushes to near maximum in the final ladder before active recovery.

Turnarounds

An example of turnarounds would be as follows:

• The distance of each interval to be run is 400m.

• The work plus rest time is set at three minutes.

• The client then selects their own pace to run the distance.

• The faster they run to complete the 400m, the longer the rest they will have before beginning the next interval. The slower they run, the shorter the rest they will have before the next interval must start.

Turnarounds can be tailored to suit any level of fitness by manipulating the distance and time variables. However, they are most suited to fitter and better—trained clients who have a more competitive attitude to training.


Sprint intervals (creatine phosphate system)

Sprint intervals are characterised by short, very high-intensity work intervals, followed by relatively long recovery periods. Work intervals are typically 10-60 seconds long, with a work-to-rest ratio of about 1:3. All-out efforts at the fastest possible speed are often called ’peaking sprints’.

Working at this level of intensity stimulates the fast twitch muscle fibres and improves the anaerobic energy systems. From a performance perspective, sprint intervals will increase the muscles’ utilisation of the creatine phosphate energy system and tolerance to large amounts of lactic acid. The nervous system becomes more efficient at stimulating faster muscular contraction rates.

The graph above shows sprint intervals - short intervals at maximum intensity.

Tabata Intervals

Research carried out at Japan's National Institute of Fitness and Sport in Kanoya demonstrated that a workout lasting just four minutes using intervals of short duration and maximum intensity can be effective for increasing aerobic fitness (Tabata, 1997). The original research study used cycling as the exercise modality and showed a 13% increase in VO2 max after a six-week regime. This compares favourably with other training regimes using longer durations.

Tabata's method has the distinct advantage of achieving increased aerobic/anaerobic fitness in only four minutes instead of the more usual 20 minutes. This makes it particularly useful for fit, well-motivated clients who have only a limited time to train. However, the maximum intensity combined with the short rest period between intervals leads to very high concentrations of blood lactate and great discomfort. For these reasons, Tabata's method is unsuitable for clients who are not well conditioned. Protocols for how to safely set up Tabata intervals can be found by typing ’Tabata’ into an internet search engine.

When choosing how to train a client, the individual's overall goal and whether they require a specific type of training should always be considered. While short sessions have a place in improving fitness, longer training sessions will still be more appropriate for clients interested in


OBLA

Sprint intervals

Pulseraiser

Main CVworkout

Pulselowerer

losing body fat (where longer training sessions will use more kilocalories) and clients preparing for long-distance events.

Alternative environments and equipment for cardiovascular training

Outdoor walking and running

The many health benefits and accessible nature of walking as a low-cost, low-risk activity have been recognised by a number of agencies (Walk Cymru, Natural England, etc.), and many of these organisations offer national walking programmes to cater for a diverse range of clients. These schemes are often accessible for people who would not consider other forms of exercise.

In recent years, there has been a surge in the promotion of pedometers as a way of encouraging people to take the recommended 10-12,000 accumulated steps per day. There are also many personal trainers who are capitalising on this trend, diversifying their client base by including walking programmes as part of their training repertoire.

Walking - techniques

There are certain key points that need to be emphasised to ensure correct technique and maximum benefit from walking. Some are general and some are specific to each particular level of walking.

Walking offers various levels of intensity that can be tailored to match the fitness of your client and the terrain. It is likely that the majority of clients will achieve their aims by walking at levels 1 and 2.

If offering walking programmes is something you would like to branch out into, then it is recommended that you take relevant qualifications such as the YMCA Awards Level 2 award in ‘Walk leading’, as this course covers aspects such as technique for the various walking levels and safety considerations when leading a walk.

Running and walking

As a personal trainer, you could incorporate occasional outdoor walking and running into a programme. You would be expected to give the client technique tips as you would in an indoor environment, and you would also need to consider the different health and safety guidelines that would apply to an outdoor environment.

The ideal environment would be a stretch of flat ground, with the option of:

• large open spaces, for walking drills and other activities to be performed

• a range of slopes and hills, for progressing walks/runs with clients once they have achieved a reasonable level of fitness and need the extra challenge

• landmarks, such as trees, lamp posts, benches, which can be incorporated for setting targets, as well as making useful props that can be used during muscle-conditioning work


Weather conditions also need to be considered when leading walks, as would the effects and possible hazards of the terrain.

Indoor exercises

When planning cardiovascular exercise for indoor environments, such as the home or office, space is the main limiting factor. However, there are many body-weight exercises from aerobic-type circuits that can used in small spaces, involving either low- or high-impact exercise.

The following table gives examples of appropriate high- and low-impact exercises:

Resistance training - selecting exercises for different training goals

The exact choice of exercises for a particular workout, and the order in which they are performed, has a significant effect on the training outcome. A Level 2 gym instructor would have learnt how to induct a range of fixed and free weight lifts and to name the prime movers involved in each exercise. This would enable them to identify exercises to target each major muscle and combine a sequence of exercises to achieve a general whole-body workout.

This section explores in greater depth the training effects and how the body adapts specifically to each chosen exercise. Try to think beyond which muscle is working, and instead take into account the following:

• the specific movement (joint action and muscle contraction) used in an exercise and whether it relates to the client’s training goal

• the specific adaptations of the nervous system to the imposed demand and changes of the pattern of muscle fibre type recruitment within each muscle, during specific exercises

• the adaptations that occur when fixating and stabilising muscles during specific exercises

Whole-body approach

This type of general training programme should satisfy a balanced whole-body approach (WBA). It helps to develop all muscles in proportion and avoids imbalances that can lead to poor posture

Low-impact exercises High-impact exercises

Squats Jumping jacks

Knee raises Spotty dogs

Side steps Squat jumps

Hamstring curls Jogging on the spot

Back taps/half jacks Jumping knee raises

Small equipment, such as steps and skipping ropes, can also be useful


and joint injury. This makes this approach more appropriate for clients who have general overall fitness goals, as opposed to very specific or sport-related training goals.

A little thought and planning are required to achieve a balanced WBA. Compound exercises as opposed to isolation exercises, are generally recommended, because fewer lifts are required to work all the main muscles. For example, a chest press would be used to work the pectorals, triceps and anterior deltoid rather than selecting individual (isolation) exercises for each of these muscles. The main consideration is that the selection of exercises should be based upon the client's requirements and goals.

Compound and isolation exercises

You should be aware of the relative merits of compound and isolation lifts. The following table gives a brief comparison of the two types.

Isotonic and isometric

Isotonic exercise is roughly defined as ‘exercise with movement’. The prime movers contract concentrically to lift the resistance through the full range of movement, followed by an eccentric contraction to lower the resistance under control, back to the start position. In contrast, performing an isometric exercise involves ‘no movement’. The prime movers contract, but no movement occurs through the range of motion - the muscles contract to hold in a static or fixed position.

Both types of training are valid and will yield positive, specific and different training effects. The advantages and disadvantages of each method are listed in the table below. What is important is being able to know when to use them appropriately. For example, core stabiliser muscles naturally work 'isometrically' to support the spine, so, using the rule of specificity, it makes sense to train them in this specific (functional) way. Alternatively, the leg muscles naturally work 'with movement’ when running, jumping and climbing stairs; therefore, it makes sense to train these muscles using isotonic exercises, which replicate the actions they need to perform.

Compound Isolation

A multi-joint exercise, using several main muscles - e.g chest press

A single-joint exercise, using only one main muscle - e.g, overhead triceps extension

Resistance moves in a straight line - eg, lat pulldown

Resistance moves in an arc - eg, biceps curl

Tend to work muscles through their strongest mid-range

Work muscles through full range of movement (ROM), including weaker inner and outer range

Tend to recruit many small synergist and fixator muscles

Comparatively fewer synergist and fixator muscles recruited

Limbs have a good leverage advantage Limbs have a poor leverage advantage

Suitable for heavy, moderate or light resistance (you can lift more, because more muscles are involved)

More suitable for only moderate or light resistances (you lift less, because fewer muscles are involved to move the resistance)

Suitable for building basic functional strength Suitable for targeting smaller muscles and specific movements


Isometric work can be useful to include in sport-related exercise programmes when it is specific to a particular activity - ie, when the sport requires holding a position for a period of time. Some examples of this would be: a rugby forward pushing in a scrum, a wrestler using a hold down or a gymnast holding an iron cross position on the isometric rings.

The following table compares isotonic and isometric contractions:

Isometric exercises are described as 'joint angle specific’. This means they only strengthen the muscles in the particular position being held. This is usually thought of as a disadvantage to whole-body training; however, there are situations when isometric training can be used to create an advantage. Most lifts have a ‘sticking point’ in their range of movement, where the leverage limitations of the muscles and joints make it most difficult to move the resistance. For example, in a bench press, the sticking point is at the lowest point, with the bar just above the chest. Performing an isometric exercise in that specific position (using a bar locked in position on a Smith machine) will strengthen the muscles at that specific joint angle and help to overcome that sticking point.

Open and closed kinetic chain

Many physiotherapists and personal trainers refer to exercises as ‘open kinetic chain’ or 'closed kinetic chain’. However, a comprehensive review of literature on the subject has failed to provide an agreed definition of each classification. The following descriptions are based on common usage, and on the relevance of open and closed chain exercises for training a client.

The concept of a kinetic chain is derived from engineering. This is when a complex mechanism can be simplified by thinking of it as a series of rigid segments, or links, held together by pinned joints that are free to move. This simple kinetic chain model can be used to predict how mechanical linkages will behave when they move and are placed under load.

When applied to the human body, each segment in the kinetic chain is represented by the lower leg, upper leg, torso, upper arm and lower arm, etc. The pinned joints are represented by the hip, knee, ankle, spine, shoulder, elbow and wrist, respectively. By modelling the human body as a kinetic chain, the effect of different movement patterns and exercises can be analysed.

Isotonic Isometric

Trains the muscle through a full ROM Strength gains are specific to the joint angle

Easy to measure progression in strength Harder to measure progression in strength

Leads to a moderate rise in blood pressure Leads to a greater rise in blood pressure (contractions of no more than 10 seconds recommended for novices)

Trains muscles to create co-ordinated movement Useful in rehabilitation of injured joints, where movement is limited

Good transference of strength gains to activities requiring movement, such as walking, climbing stairs, standing from a chair unaided

Good transference of strength gains to activities requiring no movement, such as carrying bags of shopping, holding good posture or carrying a young child


Open chain

An open kinetic chain is roughly defined as one in which the final (distal) segment is not fixed to an immoveable object. This means that this link in the chain (the distal segment of the body) is free to move (without necessarily affecting any of the other links in the chain). Open kinetic chain exercises are therefore those in which the external object moves freely, while the body remains fixed.

One such example is the leg extension. Open chain exercises are often (but not always) single joint isolation movements.

Mobiliser (or movement) muscles tend to be most active in open chain movement, where the end of the limb is not fixed.

Other examples of open chain exercises include:

• lat pulldown (the hands hold a pulley that is not fixed, while the body remains fixed)

• biceps curls (the hands hold a pulley that is not fixed, while the body remains fixed)

• leg curl (the legs rest against a foot pad that is not fixed, while the body remains fixed)

• chest flyes (the hands hold dumbbells that are not fixed, while the body remains fixed on a bench)

• jogging on a treadmill (the foot strikes a platform that is not fixed, while the body should remain fixed)

• reaching for and grabbing tins from a supermarket shelf

• lifting shopping bags

The distal aspect of the limbs (the furthest away from the centre) is free to move in each of these exercises; they are not fixed to an immoveable object. The object they move (eg, a pulley machine, a dumbbell or the rest of the body) is able to move.

Closed chain

A closed kinetic chain is roughly defined as one in which the final (distal) segment is anchored to an immoveable object. This means that the final link in the chain is not free to move, and therefore, if a force is applied to the mechanism, the rest of the chain will potentially move as well. Closed kinetic chain exercises are therefore those in which the external object remains fixed, while the body moves freely.

One example of a closed chain exercise is a lunge. Closed chain exercises are usually( but not always) multi-joint movements.

Stabiliser (or fixating) muscles tend to be most active in closed chain movements, where the end of the limb is fixed, not allowing movement.

Other examples of closed chain exercises include:


• chins or pull-ups (where the hands are fixed)

• squats (where the feet are fixed)

• press-ups (where the hands are fixed)

• pushing a car or shopping trolley

• getting out of a chair

The distal aspect of the limbs (furthest away from the centre) is fixed to an immoveable object (eg, the floor or a fixed overhead bar) in each of these exercises.

Kinetic chain and training effect

Physiotherapists will use the concept of open and closed kinetic chains when prescribing rehabilitation exercises. Open chain isolation exercises (eg, leg extensions) tend to put greater shear and compressive forces on a joint, whereas closed chain compound exercises (eg, squats) tend to create comparatively lower joint stress. This is also dependent on the specific exercise.

Some awareness of open and closed kinetic chain movements is useful when selecting appropriate exercises and progressing and regressing exercises. For example, if we compare chins with lat pulldowns of a similar grip, we find that both exercises have the same prime movers, yet when performing chins, the body moves against a fixed object (closed chain), whereas in lat pulldowns, the body remains fixed and the resistance moves (open chain).

At first glance, it would appear that both exercises should give the same result. However, when the nervous system's recruitment of prime movers is studied in more detail (as a physiotherapist would be required to do), there are many differences in the sequence of muscular contractions and the degree to which each separate muscle is used. When comparing these exercises, the degree of transference of strength between the two exercises may be less than commonly thought. In practice, increasing the weight on lat pulldowns in order to progress to performing chins (where the body weight is lifted) might not work as well as starting with assisted chins and progressing by gradually reducing the assistance until full body weight can be lifted. A further consideration would be which exercise is most relevant to everyday function for individual clients. For example, do they often have to pull a heavy resistance down towards them (eg, the lat pulldown), or are they more likely to need to pull their body upwards using their arms (eg, chins).

Exercise order

There are many different views and opinions on the order in which order exercises should be performed, but the order you use should depend on your client and their training goals. Below are some commonly followed guidelines:

• For beginners and some specialist client groups (14- to 16-year-olds, older adults, etc.), it is preferable to alternate exercises from upper to lower body to avoid excessive fatigue in specific areas.

• Advanced clients may generate greater intensity by focusing on the same muscles for several consecutive exercises — eg, back squats, followed by lunges, then leg extensions. This method is used in training systems like tri-sets and giant sets.


• As a general recommendation, compound exercises training large muscle groups are used first (eg, dead lifts, bench presses, etc.), This is because such exercises tend to require greater energy, effort and concentration to adhere to correct technique. However, smaller muscle groups also get exercised at the same time. If isolation exercises are performed first, this causes fatigue in the smaller muscles, making the subsequent compound lift less effective. An example would be a triceps push-down followed by a bench press (the fatigue in the triceps would make it very difficult to overload the pectorals in the bench press). Despite this, advanced clients often deliberately use a similar technique to ’pre-exhaust’ specific muscles.

• If cardiovascular benefits are the principal goal of training, it makes sense to choose a circuit approach and an exercise order that alternates regularly between large muscles. ‘Peripheral heart action’ training deliberately utilises a sequence of lifts that forces the body to shunt blood constantly to different areas, preventing pooling in any particular part.

Variations of basic lifts

All personal trainers should have a wide selection of resistance exercises to call upon in order to accommodate the requirements and differences of individual clients. The following table lists basic lifts and suggests some example variations (this is just a selection; there are many more). You will need to apply your knowledge when working with specific clients to select the appropriate lift or variation - not all exercises are appropriate for all clients.

Movement Basic lift Example variation

Compound leg movement Squat Single leg squatFront squat

Lunge Split stance lungeDumbbell or barbell

Deadlift Wide or narrow stanceSmith machine

Isolation leg movement Extension Both legs or alternate

Curl Seated or lying

Calf raise Different foot positionsSeating or standing

Pushing movements Bench press Incline or declineDumbbell or barbell

Shoulder press In front of or behind headSeated or standing

Pulling movements Lat pulldown Various gripsVary angle of body

Seated row Bent over rowStanding cable row

Pull ups (chins) Various gripsAssisted or bodyweight


Any modification or adaptation to an exercise will slightly change the effect it has on the body. For example, a lift performed standing will require more support and stability from the legs compared with performing the same lift in a seated position, and an inclined bench press will engage more of the upper pectorals than a flat bench press. Therefore, not only should you know a wide range of lifts, but you should also be aware of the different effect that each one has, and when it is most appropriate to use which version with each client.

Functional exercises

Functional exercises can be defined generally as those that improve muscular fitness in such a way that they help the client to perform specific functions, such as everyday tasks. This is in contrast to exercises that are aimed at simply making the body look better. The emphasis on functional exercises has gradually become more accepted and widely used.

To train the body to perform a particular function easily, it is important to apply the SAID principle of specificity:

Specific Adaptation to Imposed Demand

The body will adapt specifically to the demand imposed upon it. For example, if a person runs regularly, their body adapts accordingly and their running improves. However, this doesn't make them a good cyclist or swimmer, because the demands that cycling and swimming place on the body are different from those of running. A person who performs leg extensions regularly will develop strong quadriceps, but this will not necessarily make them good at lunges or squats, because the stresses placed on the legs are not the same as for these exercises (especially in terms of balance, stability and co-ordination of several joints at once).

Therefore, to train effectively for a particular function, we need to target and overload muscles, joints, balance, co-ordination and stability in the specific movement pattern required. In other words, we need to mimic the required function as closely as possible during training. Consider the following everyday activities that require muscular effort:

• climbing stairs

• standing up from a chair unaided

• carrying a young child

• painting a ceiling

Rather than analysing all the muscles involved in a particular action, it is simpler to analyse the movement being performed. For example, if we wish to strengthen the legs to make climbing the

Isolation arm movement Bicep curl Preacher curl

Triceps extension Cables of dumbbells

Movement Basic lift Example variation


stairs easier, then it makes sense to use a step-up action rather than a leg press, leg extension or squat. The step-up most closely simulates the real-life action of climbing stairs (a primarily closed kinetic chain movement in which one leg raises the full body weight through the outer range of movement at the knee, while engaging various stabiliser muscles to prevent the pelvis dipping, simultaneously keeping the rest of the body balanced.

The obvious issue here is if we simply lead an active life, and perform these everyday tasks on a daily basis, then we would regularly achieve the necessary training effect. However, as the evidence presented earlier indicates, modern-day lifestyles are generally sedentary and people are generally relatively inactive.

Performing functional exercises in a controlled training environment offers two main advantages over the real-life (daily activity) situation:

• As the personal trainer, you can encourage your client to do the exercises and reach a point of overload. Outside of structured exercise, people tend to avoid physically demanding tasks and gradually lose their functional ability. Just think about the number of adverts for labour-saving or assisting devices such as stair lifts, walk-in baths and garden tools designed to make life easier by taking the effort out of everyday tasks.

• In a training environment, exercises can be modified and progressed safely. For example, a step-up could be done using support if balance is a problem. The client could start off with a low step and gradually increase the height (which is not really possible using the stairs in a client's home). Additional resistance can also be added by using dumbbells or a weighted vest.

Resistance training - strength, hypertrophy or endurance

The most common resistance training goals are to increase muscle strength, to develop muscle hypertrophy (bulk or size) or to improve muscular endurance.

This section explores how to train to improve each of these by manipulating the ’short-term variables’ — the sets, repetitions, resistance, choice of exercises, etc. The ‘long-term variables’ are explored in the section on periodisation.

The muscular strength and endurance continuum

This continuum ranges from absolute strength at one end to muscular endurance at the other. There is no absolute cut-off point where endurance starts and strength training ceases, or vice versa. Rather, there is a gradual shift in emphasis along the continuum. The strength and endurance continuum:

Strength Strength/endurance Endurance

Heavy resistance Heavy/moderate resistance Moderate resistance

PC energy system PC/LA energy system LA/O2 energy system

1-8 repetitions 8-12 repetitions 12-25+ repetitions

Fast twitch muscle fibres Mix of fibre types Slow twitch muscle fibres


Various researchers have made recommendations about the exact repetitions and resistance to be should in order to achieve particular goals (NSCA, 2000). Perhaps the most notable feature of these guidelines is that the greatest hypertrophy gains happened in the 8- 12 repetition ranges, with moderate resistance. This is contrary to the popular belief that very heavy weights must be lifted to build bulky muscles. Resistances of SRM and heavier do increase strength, but they seem to do so by increasing the ‘neural drive’ to the muscles (ie, improving the recruitment of fibres by the nervous system). Increase in muscle size (myogenic/muscle adaptations) seems to be less of a factor.

Example of repetition ranges and training effects

While these guidelines can be useful for the purposes of writing a periodised programme, it is worth stating that not everyone agrees on the repetition and resistance ranges recommended here and research is constantly being updated. The ACSM (2006) takes the view that there is little difference in strength/endurance or hypertrophy gains between 3-20 repetitions, as long as the exercise is taken to a point of overload and a maximum voluntary contraction is achieved. The ACSM (2006) also questions the use of percentage of 1 RM to set the resistance, because research has shown that this varies so much between lifts (it seems to be particularly inaccurate for lifts involving the large leg muscles, such as for the leg press, squat or lunge). An important point to consider is that it is inappropriate to test 1RM with the average client, who is likely to be inexperienced, unfit and lacking in motivation.

A more pragmatic approach is to decide upon the repetition range that is most suitable for the individual client and their goals, and then, by a process of trial and error, to find the resistance that takes them to a point of overload. For healthy people, overload equates to an RPE of 19-20 (’very, very hard’) on the final repetition.

If this proves too demanding for your client, then a more modest degree of overload can be used, indicated simply by watching for an obvious slowing in the performance of the concentric phase of the lift, or an RPE of 15-16 (‘hard’) on the final repetition. This approach may be more appropriate for untrained clients and those in specialist groups, who will need to work at a lower intensity.

Repetitions Approximate percentage of 1RM Effect

1-5 85-100% Increased strength via enhanced neural drive

6-8 75-85% Maximum strength, plus some hypertrophy

9-12 70-75% Best hypertrophy gains

13-20 60-70% Decreasing strength and hypertrophy gains.Increasing endurance gains


Muscle fibre types and training implications

The characteristics of the three different muscle fibre types is covered in detail in the ’Anatomy and physiology for exercise and health’ chapter, in the section on muscle and muscle actions.

If an individual trains for muscular endurance, adaptations will occur in slow twitch ‘type-one’ fibres only. The type-one fibres will result in hypertrophy, causing a greater relative area of type-one fibres and a smaller relative area of type-two fibres within the muscle. This will result in greater endurance capacity and a decrease in strength capacity. Decreases in muscle mass may also occur, as slow twitch fibres are lower in mass than fast twitch fibres. To gain maximum strength, type-two fibres must be recruited. This implies lifting heavy weights. If the aim of the training programme is to increase strength by placing emphasis on the neuromuscular system, then the individual needs to use a very low repetition range, using extremely heavy loads. This type of training will increase potential muscular force production by improving the neuromuscular processes involved in simultaneous recruitment, as well as the frequency of stimulation of motor units.

If the aim of the training programme is primarily to increase hypertrophy, then the training programme needs to stimulate as many fibres as possible. This implies using moderate repetitions and moderate loads (in the 8-12 range), where both fibre types are involved. It also implies training a muscle at many different angles to make sure all the different fibres in different parts of the muscle are recruited and taken to overload.

Summary of training guidelines

The following tables show how to set the main variables for a training programme, depending on whether the client wishes to develop strength, hypertrophy or endurance, respectively.

Strength training guidelines

Property Beginner Intermediate Advanced

Frequency 2-3 times per week 2-4 times per week 4-6 times per week (split routine)

Loading 60-70% of 1RM 70-80% of 1RM 80-100% of 1RM

Volume 1-3 sets8-12 reps

Multiple sets of 6-12 reps Multiple sets of 1-12 reps periodised

Velocity Slow to moderate Moderate Varying:Super slowSlowModerateFast

Exercise selection Compound (multi-joint) and isolation (single-joint)Emphasis on compound

Exercise order Large muscles firstCompound/high intensity exercises first

Rest intervals 2-3 minutes for high-intensity exercises, 1-2 minutes for others


Hypertrophy training guidelines





Multiple sets of 6-12 reps Multiple sets of 1-12 reps periodised, emphasis on 6-12 reps

Velocity Slow to moderate Slow to moderate Varying:SlowModerateFast


Exercise order Large muscles firstCompound/high intensity exercises first

Rest intervals 1-2 minute, 2-3 minutes for heavy compound exercises

Endurance training guidelines





Multiple sets of 10-15 reps

Multiple sets of 10-25 reps periodised

Velocity Slow to moderate Slow to moderate Varying:SlowModerate

Slow velocity for sets of 10-15 repsModerate velocity for higher reps


Exercise order Variety in sequencing is recommended

Rest intervals Less than 1 minute for sets of 10-15 reps1-2 minutes for higher reps


Alternative environments and equipment for resistance training

Small equipment and alternative environments

When using environments other than the gym (indoors and outdoors), portable equipment can be very useful. Here are some examples:

Resistance bands/tubes

Resistance bands can be very useful and easily portable tools for personal trainers. They are supplied in various forms, sometimes in a roll so that lengths can be cutoff as required, while others have handles attached to either end. Different colour bands usually denote different resistances, making them a versatile piece of equipment for working with a wide range of clients. They can be used to mimic a wide variety of lifts as performed with weights in the gym. Systems involving sticks that attach to the bands to provide a ‘bar’ to work against are increasingly popular.

Weighted bags

Although not as portable, weighted bags (and other weighted equipment with handles) have become very popular as a tool for functional training that can be performed in a variety of environments and are excellent for use in home training.

Medicine balls

As with weighted bags, these are not easily portable, but are very versatile for functional training in the home and other environments.

Outdoor gyms

Many public parks now have outdoor gyms (sometimes known as ‘trim trails’), usually offering a variety of equipment that can be used in conjunction with body weight to offer a resistance workout. Often included are chin-up bars, bars/handles for clips, Incline/decline benches for press-ups/abdominal curls, etc., platforms for step-ups/lunges and other variations.


Cable machines

These include high and low pulley machines, cable cross-over machines and various dual-axis pulley machines. The exerciser holds onto handles that can move in any direction, allowing much greater freedom of movement for the user and enabling the performance of a wide variety of exercises. This equipment also means that many everyday movement patterns or sporting movement patterns can be closely simulated - eg, the throwing movement for javelin or a leg sweep movement to pass a football.

To some extent, these machines are also more accommodating for clients who use a wheelchair, as a number of regular exercises can be performed by adapting the position of the cable to suit any restrictions to their movement. Using these machines will also demand additional work from fixating muscles, so your client's functional limitation (and stability) should also be considered. if you want to work with disabled clients, you should seek additional training to fully understand the needs of each individual.

Vibration training

Vibration training machines have become a common feature in the modern gym, and home versions are also available. Although they are used in a variety of training approaches, the main benefit is improving responses to resistance training. Using a vibrating plate that moves in either two or three dimensions (depending on the specification of the machinery), the body is subjected to acceleration forces that cause reflex actions in muscles when performing body-weight exercises such as squats. Studies have shown that these reflex actions can cause a greater-than-usual recruitment of fibres, giving results that would be over and above those expected when working with body weight alone.

Equipment specification and programmes vary widely - manufacturer guidelines should be consulted before using vibration equipment to train clients.


Flexibility training

Clients who regularly participate in exercise programmes and are ‘very fit’ often devote comparatively little or no time at all to stretching. Flexibility is neglected because the results, in terms of aesthetics or better performance, are usually less obvious when compared to the results from resistance training, cardiovascular training or skills training.

In this section, the basic principles of stretching are revised and some of the different methods of stretching are explored.

Overview of basic principles Flexibility is the ability to achieve maximum range of movement around a joint or series of joints. Stretching is not always beneficial for all muscles. A programme designed without much thought that simply calls for stretches of ‘all the major muscles’ may actually be ineffective for many clients and the reasons for this are set out below.

First, the purpose of stretching is to maintain or increase ROM around a joint. If a client has insufficient ROM around a particular joint, stretching the muscle(s) that are restricting that ROM will be beneficial. If the client already has sufficient ROM around a joint, then the main benefit of stretching would be to maintain that ROM in the long term. if the client already has excessive ROM around a joint, then stretching would not be beneficial. In fact, it may be harmful because it would lengthen a muscle that is already too long. Remember that muscles work in opposing pairs, and there should be a good balance of strength and length between them. If one muscle is too long, then the opposing muscle is likely to be too short and tight. This has a negative effect on joint stability and muscle function. Stretching the lengthened muscle simply leads to even worse muscle balance. Instead, it is the short, tightened muscle in the pair that should be stretched.

Second, some clients are naturally very flexible in all joints ('hypermobile’). Increasing their ROM further is contraindicated. Instead a programme of muscle strengthening and movement control would be more appropriate to improve their joint stability and decrease risk of injury.

It is essential to assess a client's flexibility before selecting which muscles to stretch. With experience, this can be done visually, by simply observing how easily the client is able to perform a range of stretches. Alternatively, many standard tests have been developed to assess flexibility on a more formal basis (Kendall, 1993).

The health, fitness and medical professions have developed many different methods of stretching muscles with the purpose of improving flexibility. Below is a brief review of the main methods of stretching that are most relevant to personal trainers (as opposed to those used by physiotherapists for rehabilitation purposes).

Types of stretching

Slowly applied static stretch

This type of stretching requires that the muscle is lengthened slowly until mild tension is experienced in the bulky part of the muscle. The stretch is held statically for up to 60 seconds (depending on the purpose of the stretch). A static stretch may be held actively or passively (below). The use of static stretching is well established in health-related fitness. Improvements in


flexibility appear to result from desensitisation of the stretch reflex and lengthening of tightened connective tissue ('developmental’ stretching).

Dynamic stretch

This refers to stretching 'with movement’ (ie, the muscle is being continually lengthened and then shortened, without being held at full length for any significant duration). Movement should be with control - eg, circling the shoulders through their full range at a moderate speed or bringing the heels up to touch the backside (leg curls). If the stretch is applied with rapid, explosive movements several times in a bouncing fashion, this is referred to as a ’ballistic' stretch. Examples would be high-kicking the legs or bouncing toe touches.

Dynamic stretches are considered less safe than static stretches because of the greater speed involved, requiring less control of the limbs and possibly leading to overstretching. This is especially true with clients who lack body awareness to control their movements. Safety may be compromised further for ballistic stretching. The rapid stretching movement will invoke the stretch reflex, causing the muscle being lengthened to simultaneously contract. This can lead to repeated small tears called micro traumas Over a long period, this can lead to a build-up of scar tissue that may actually reduce flexibility rather than increase it. Despite the safety issues, dynamic stretching may prepare muscles more fully for rapid lengthening of the type encountered in most sports (Norris, 1994).

Active stretch

An active stretch makes use of the fact that muscles work in opposing pairs. Stretching (lengthening) of the antagonist is brought about by contraction (shortening) of the agonist. One example is lengthening the quadriceps by contracting the hamstrings (when standing, lifting the heel towards the buttocks, without supporting the foot).

An active stretch can be performed either statically or dynamically. The above is an example of a static active stretch. A dynamic active stretch would occur when performing leg curls, for example.

Active stretching is a natural function of the muscles and is the type of stretch encountered when performing many sports and everyday activities. Active stretching uses ’reciprocal innervation’ between muscles. This means that when the agonist contracts, the nervous system will automatically cause a ’reflex inhibition’ (relaxation) of the antagonist so that movement can occur.

ACSM guidelines for stretching

Frequency Minimum of 2-3 times per week

Intensity 3-4 reps per muscle group to the end of range of movement, without inducing discomfort

Time 15-60 seconds for static. A 6-second contraction followed by a 10-30 second assisted stretch for proprioceptive neuromuscular facilitation (PNF) techniques

Type Static, dynamic or PNF (ballistic may be considered for people whose sporting activities involve ballistic movements)


If this did not happen, both muscles would oppose each other and the limb wouldn't move. Hence, the reflex inhibition of the antagonist, and the resulting relaxation, is thought to help obtain a better stretch. Better muscular control throughout the full ROM may also result from active stretching when compared to passive stretching, and this may be beneficial to joint stability (Alter, 2004).

One drawback with active stretching is that it relies on the agonist being strong enough to stretch the opposite antagonistic muscle. For that reason, it is often ineffective when used in health-related sessions. In the example given above, trying to actively stretch the quadriceps by contracting the hamstrings is only moderately effective in most people and will be determined by the strength of the hamstrings to lift the heel as close as possible towards the buttocks.

Passive stretch

A passive stretch means that an external force causes the stretch. This can include leaning on a wall, holding the leg, partner assistance, gravity, etc., allowing the agonist muscle to be relaxed.

Using the same example of lengthening the quadriceps by contracting the hamstrings, holding the foot with the hand should allow the hamstring muscle to relax and a larger range of motion can be achieved.

Passive stretches can also be performed statically or dynamically. The effectiveness of passive stretches does not rely on the strength of the agonist to stretch the target muscle. They can therefore be easy to perform and comfortable to hold, hence their common use in health~related flexibility. However, if used inappropriately, they may promote ROM beyond that which the muscles are capable of controlling. When this happens, they may potentially be detrimental to joint stability in the long term.

Proprioceptive neuromuscular facilitation (PNF) stretch

PNF, or ‘facilitated’, stretching is a term used to describe a number of techniques that originated in physiotherapy and that are commonly used to increase flexibility.

Essentially, the muscle to be stretched is first placed under tension by isometric contraction. When the contraction is released, the muscle appears to become temporarily more relaxed than usual. The muscle can then be stretched well beyond its usual range - often to a surprising degree. The increased range of movement is not permanent, but continual use of PNF stretching will bring about a long-term increase in range of movement.

The usual explanation for this temporary relaxation of the muscle is that the isometric contraction causes the Golgi tendon organs (GTOs) to fire, which triggers a reflex for the same muscle to relax. This process is termed ’autogenic inhibition’. It is worth noting that not all research agrees on this explanation, and the exact reason for the greater relaxation in the muscle is not fully understood (Alter, 2004). The intensity and duration of the isometric hold necessary to bring about optimum relaxation remain the subjects of research and debate.

PNF stretching is considered less safe than normal static stretching because of the degree to which the muscle is being elongated. PNF techniques often require the use of a personal trainer, who needs knowledge and experience to avoid overstretching the muscle and causing strains. However, there are also several effective positions to self-apply PNF stretches to various muscles. Performance Training Academy 83

Two methods of PNF

1. Contract-relax (CR) 2. Contract-relax-antagonist-contract (CRAC)

These two methods have been selected because they are the simplest PNF techniques to apply and do not place excessive demands on the client in terms of time, muscle strength and body awareness.

Contract-relax technique (CR)

CR is referred to as ’hold-relax’, or ‘post-isometric relaxation’. This is the simplest PNF method to use.

Contract-relax-antagonist-contract (CRAC)

CRAC is the same as CR for the first few steps. However, during the final relaxation and stretch phase, the agonist muscle is instead actively contracted to stretch the muscle to its new length, rather than it being passively lengthened. In theory, this makes use of reciprocal innervation, which causes reflex inhibition, leading to even better relaxation in the antagonist muscle being stretched.

Example: lying hamstring stretch

1. Raise the leg towards the chest to achieve a stretch of the hamstrings. 2. Contract the hamstring muscle against a resistance. 3. Relax the muscle. 4. Contract the quadriceps muscle (antagonist) to move further into the stretch. 5. The muscle can then be relaxed and moved further into the stretch to bring about a further increase in range of motion with passive partner assistance.

It is debatable whether PNF stretching in the long term is better than regular developmental stretching for increasing range of movement. The technique is popular among personal trainers because of the impressive immediate results and because of the interdependence between client and trainer that may result from using partner-applied stretching. It also provides the trainer with an opportunity to be more active in supporting the client.

Precautions

CR technique

• The client should be thoroughly warm• The muscle to be stretched is lengthened until mild tension is felt• In this position, the muscle is then contracted isometrically by pushing against an immoveable object

(6 second contraction) and approximately 50% maximum effort• The muscle is then allowed to relax briefly in position, before being passively stretched to its new

length and held for 10-30 seconds• The process can then be repeated


In general, there is very little need for personal trainers to touch their clients or to use hands-on teaching in the course of their job. YMCA Awards believes that good personal trainers should have sufficiently developed visual and verbal teaching skills to allow them to assist their clients to achieve safe and effective exercise technique without the need to touch. However, if touching is necessary, then it should be used appropriately and for a clear and specific purpose, such as applying a PNF stretch more effectively.

The following should be used as a guide when using a hands-on approach to teaching:

• Ask the client's permission first and be sensitive to personal differences (gender and religious background) that may make hands-on teaching inappropriate.

• Use the information from screening processes and fitness assessments to identify any potential contraindications - eg, an old injury or condition that may be aggravated.

• Communicate clearly: explain what you are going to do and regularly ask the client for feedback to check that what you are doing is comfortable and effective.

• Use positions that are stable and safe.

• Beware of invading your client's personal space too much.

• Avoid any joint manipulation techniques unless you are fully qualified to use them (such as if you are qualified as a physiotherapist, osteopath or chiropractor).


Motor skills training

A motor skill is a function that involves the precise movement of muscles to perform a specific act. A person may have a high degree of fitness in other components (strength, endurance, flexibility, etc.) but moving skilfully and efficiently requires their muscles to be recruited and controlled in the correct sequence by nerve impulses.

Using a car analogy, the muscles, bones, circulation and heart are like the engine, chassis, suspension and wheels. The brain and nervous system are the driver and the steering. No matter how good the car is, it cannot function well without a good driver behind the wheel.

This section provides some simple definitions of the components of motor fitness and offers some basic training guidelines for the personal trainer, building on the knowledge already gained at Level 2. Trainers interested in developing a greater knowledge of motor skills are advised to consider the sport conditioning unit as part of their on-going CPD.

Motor skills can be subdivided into the following components:

• balance

• reaction time

• agility

• co-ordination

• speed

• power

If we want to improve our motor fitness, we must specifically and repeatedly train the motor skill we wish to improve. Training to improve each subcomponent of motor fitness will require different and specific activities. For example, performing a quick, co-ordinated sequence of movements will require the practice of the specific movements that make up that sequence. Improving balance will require different training than that required to develop power, for example. The application of the skill (the sport or athletic event) will also demand a specific training focus (Lawrence and Hope, 2008).

Balance

Balance is the ability of the body to evenly distribute weight in order to maintain a centre of gravity that lies on a vertical line within its base of support. Balance is achieved by using feedback from vision, from proprioceptors in the muscles and joints and from the semi-circular canals in the ears, which inform the brain of subtle alterations required to correct body position.

In a static situation, such as standing still, the body does this fairly easily, using the muscles around the ankle and knee joints to correct any tilt and sway. In fact, the body does the job so well that we are usually unaware of anything going on. However, if something happens to impair the speed of the nervous system (such as taking in too much alcohol), balance becomes more of a challenge, and body sway definitely becomes more noticeable.

Balance test


A simple way to test balance is to stand on one leg and to time the duration that the position can be maintained. Standing on one leg reduces the base of support and so accentuates the usual tilting and swaying. Closing the eyes at the same time poses an additional challenge, as this removes any visual feedback and makes it harder to balance. A further challenge is to place the hands over the ears, so that hearing is also reduced. With all the sensory balance receptors removed, maintaining balance will become more difficult. The test can be repeated on each leg.

Reaction time

Reaction time refers to the ability to respond quickly to a stimulus and then to initiate the appropriate response. The type of stimulus can vary and include:

• Visual stimulus: we see a car coming towards us as we cross the road and respond by moving out of the way.

• Auditory stimulus: we hear a loud noise behind us and respond by turning to check what it is.

• Kinaesthetic stimulus (sense of movement, feeling and touch): we feel the skin burn when we touch a hot object and respond by moving the hand away quickly.

Reaction time is largely fixed by the conduction speed of nerve impulses along sensory and motor neurons. The duration of the processing time - required within the central nervous system to initiate the appropriate response - can be reduced with practice.

Agility

Agility is the ability of the individual to change direction as quickly as possible, while still maintaining control of the body. An everyday example is steering a shopping trolley around a busy supermarket. Agility is closely related to reaction time and the ability to maintain balance.

Co-ordination

Co-ordination refers to the ability of the nervous system to recruit muscles in the correct order and at the correct force and speed to achieve a smooth and efficient movement. Often the movement pattern is complicated, involving several limbs all at once. Co-ordination is a basic requirement in all sports.

Skilled performers make activities appear ‘easy’, when often there is a series of well-timed and highly co- ordinated processes occurring to achieve the look of ‘ease’. Skilled performance demands practice and repetition to refine movement patterns to high levels.

When learning a new skill, a lot of conscious control is needed initially. As a skill develops, the process becomes more automatic, almost unconscious. An example is when an individual learns to drive, whereby initially the mind is racing between controlling the gear stick, foot pedals, looking at the road, etc., but eventually, all of these are managed without such conscious thought (Lawrence and Hope, 2008).

Speed


Speed is simply the ability to cover the most distance in the shortest time. This does not necessarily refer merely to running forwards in a straight line; it also includes the ability to move laterally (Sideways movements) and backwards. Therefore, speed is closely linked with reaction time and agility. Speed Can also be used when referring to the movement of a limb.

In resistance training, a high correlation exists between the resistance to be moved and the speed Of the movement. A light resistance, such as a ball, can be moved at high speed, whereas a heavy resistance, such as an Olympic barbell, can only be moved at a much slower speed. As a general rule. the heavier the resistance, the more the speed will be affected by strength; the lighter the resistance to be moved, the more the speed will be affected by motor skills.

Power

Power is a combination of strength (force) with speed (velocity). For example, if person A can move 100kg by one metre in one second, and person B can move the same weight the same distance in just 0.5 seconds, Person B can generate twice the power of person A. Thus power is related to movement time. If movement time is improved, power will be improved.

Power = force x speed

General power training guidelines Power training involves moving a resistance at speed. This is in contrast to regular resistance training, in which slow and controlled movements are usually recommended. A general prescription for improving power is to use a moderate resistance for a medium to high number of repetitions, performing the movements as quickly as possible.

The two prescriptions are similar, with slight variations in the resistance and repetition ranges. The exact regime that best suits one individual will be influenced by many factors.

General prescription for power training (Bompa, 1994)

Resistance 50-80% of 1RM

Repetitions 8-20

Sets 4-6

Rest between sets 3-5 minutes

Exercise speed Maximal with good technique

General prescription for power training (Sharkey, 2002)

Resistance 30-60% of 1RM

Repetitions 15-25

Sets No recommendation

Rest between sets No recommendation

Exercise speed Maximal with good technique


Training with a moderate resistance at high speed has been shown to improve movement speed regardless of if the participant has to move high, moderate or low resistances in their chosen activity. In other words, there is transference of power improvement to both heavily and lightly resisted movements.

Training with very heavy resistances does not appear to give the same overall benefit to speed. Although the participant's strength increases, the muscle's ability to contract quickly when lightly loaded does not improve. Thus, if the aim is to throw a ball further (light load) or throw a faster punch (light load), heavy resistance will have little effect.

Similarly, training with very light resistances will improve the muscles’ ability to contract quickly when lightly loaded, but this does not appear to help when the muscle must contract quickly under moderate or heavy loads. Thus, if the aim is to increase throwing distance with a heavy load, then training by throwing a light object will have little effect.

Put simply, heavy training will improve the speed of heavily loaded movements, but will have little effect on the speed of lightly loaded movements, and vice versa. Training with moderate loads appears to improve speed across the entire range of loads (lkai, 1970; Kanehisa and Miyashita, 1983).

Plyometrics/stretch-shortening cycle (SSC)

Plyometrics is a popular name given to a particular type of explosive power training‘ A plyometric exercise is one in which an eccentric (lengthening) phase of contraction immediately precedes a concentric (shortening) phase - eg, squatting down and then jumping explosively into the air. In doing so, the muscle is pre-stretched and can create a greater concentric force than when it is at its resting length. This process is also referred to, more correctly, as the stretch-shortening cycle (SSC). The SSC is an integral part of everyday movement - eg, in walking or running, the calf and quadriceps both go through an SSC every time the foot strikes the ground.

Two factors may contribute to the increased force obtained from a pre-stretched muscle:

1. The natural elasticity of the muscle/tendon unit: the principle is exactly the same as stretching a rubber band and then letting it spring back; the band recoils, releasing its stored-up energy. The more the band is stretched, the stronger it will spring back.

2. The stretch reflex: when the muscle/tendon unit is rapidly lengthened, the muscle spindles will detect this and, to prevent overstretching and damage, will trigger an instant and forceful contraction to shorten the same muscle.

An example of a plyometrics exercise is a vertical jump test, in which an individual first bends their legs to lower their body (eccentric phase), followed immediately by straightening their legs to propel their body off the floor (concentric phase).

This concept is easy to test. First, perform a vertical jump from a static bent-leg position and measure the height of the jump. Then try the same jump, but lower quickly into the bent-leg position before instantly springing up and measure the height jumped. The jump should be higher using the second method.

Between concentric and eccentric phases there is a very brief static contraction known as the ‘amortisation’ phase. Limiting the amortisation phase is crucial. if it is too long, then the stored


elastic energy (potential for recoil) from the pre-stretch is lost in the form of heat instead of being used to propel the muscles into action.

The main focus of plyometric training is to reduce the duration of the amortisation phase and transfer as much of the potential energy as possible from the eccentric phase into the concentric phase. Three main body adaptations appear to contribute to this reduced amortisation phase:

1. Intermuscular coordination - better co-ordination of muscles through the full range of movement 2. Intramuscular co-ordination - better recruitment of muscle fibres within the muscles 3. Stronger nerve impulses travelling to the muscles, leading to a more forceful contraction

The concept of plyometrics training is not new; it dates back at least as far as the ancient Greeks, although they did not use the same word for it. In Eastern Europe, ’jump training’ was used extensively from the 1950s onwards and was one factor that contributed in that era to the great successes of the former USSR and East Germany in track and field events.

Other countries inevitably copied the same training methods, and in 1975 an American coach called Fred Wilt introduced the actual term ‘plyometrics’. Nowadays, the term ‘stretch-shortening cycle’, SSC, is becoming more accepted because it describes this type of training more accurately.

The key anatomical and physiological system for training motor fitness is the nervous system; this is covered in the ‘Anatomy and Physiology for Exercise and Health’ chapter.

Adaptations to motor skills training

When a particular movement pattern is repeated again and again, the body gets more and more used to doing that movement. Less and less effort is required to replicate the skill each time, until eventually the whole movement becomes automatic, requiring no conscious thought. At Level 2 the three stages for learning a new skill were introduced. These include:

1. cognitive 2. motor 3. automatic

Cognitive

'Cognition' refers to the mental process by which knowledge is acquired. At the cognitive stage the skill is being attempted for the first time. Concentration needs to be high and participants will tire easily. Movements need to be broken down into simple components; therefore, lots of demonstration and instruction is required.

Motor

At this stage the client knows what is required to achieve the skill; they simply do not have the refined motor control to achieve it. Repetition and practice is essential now, together with reinforcement and correction of technique. Component moves can now be linked together. Concentration is still high, but the results are smoother and appear more competent. Clients should remain at this stage until movement patterns are correct. An example of this is that after Performance Training Academy 90

several driving lessons most people still need considerable conscious effort (thinking) to avoid mistakes.

Automatic

At this stage the movement pattern can be performed smoothly and at full speed without conscious attention. It can also be performed well under stressful conditions. The skill is now more or less permanent, although it may slowly deteriorate with long periods of non—use. An example of this is that experienced drivers do not need to think consciously about controlling the car, and they are free to talk or listen to the radio at the same time.

Unfortunately, if the skill is learnt incorrectly in the first place, it is very hard to modify once it has become automatic.

The nervous system appears to adapt to training as follows:

• Constant repetition of a movement causes new and stronger nerve connections to grow within the central nervous system (brain and spinal cord). This makes a stronger, faster pathway between incoming (sensory) and outgoing (motor) impulses. In other words, the decision-making process is sped up. This enables the central nervous system to fire messages to the muscle more rapidly, resulting in an improved performance. It is also the reason why a skill is difficult to 'unlearn' because, once established, the nervous system will always favour the easier and known pathway.

• Motor units are recruited in a more efficient pattern, resulting in a smooth movement and using less energy for the same task.

• Less conscious effort allows the autonomic system to relax (the participant is not so ’stressed'), which causes less interference with the smooth movement.

• For movements requiring maximal effort against a high resistance (eg, power lifting), the nervous system is able to recruit more motor units simultaneously to create more force. Training enables the nervous system to overcome the body's natural safety mechanism that inhibits the recruitment of the majority of motor units in a muscle at once.

Guidelines for training motor skills

Specificity

It is essential for the personal trainer to remember the principle of specificity. Any drills or activities that are used to train motor skills must closely replicate the movement pattern that is trying to be improved.

To perform a specific dance move will require that specific movement to be broken down and practised and added together, so that the complete sequence can be performed. Similarly, to learn a more complicated resistance lift (the bent arm pullover, lying triceps extension or clean), will require practice of individual parts of the movement, without resistance or with a lighter resistance initially until the full movement can be performed.


Repetition

Repetition is the basis of any skills training. The more often a movement is repeated, the greater the adaptation of the nervous system, until it can do it without conscious thinking (automatic). Exactly how many repetitions are needed to achieve this is hard to say. One key factor is to ensure that sufficient rest is also allowed between training to allow time for the body to recover. Another key factor is repetition of the correct pattern, as repetition of an incorrect pattern will be learnt just as easily.

‘Whole-part-whole’

Complex movement patterns can be taught by breaking them down into smaller and simpler components:

• Whole - the whole complex move is demonstrated so the client knows what it looks like. •• Part - the complex move is broken down into smaller and simpler components that can be

practised and mastered separately by the client. •• Whole - the components are then combined together sequentially and practised, so that

eventually they flow smoothly together to result in the correct performance of the complex move.

An example of this is that learning a dance move will require the basic foot patterns to be learned initially; these can then be combined with directional moves and the addition of arm lines. A common resistance training approach that utilises this learning style is the ‘clean’. Its complex nature involves breaking down each phase into its component parts. The parts are eventually put together.

Speed

Complex and fast skill patterns can be slowed down initially, so the client can learn the correct movement pattern and then gradually built up to competitive speed.

Do not train when fatigued

Motor skills are best trained when the nervous system is fresh and not fatigued. Precision and concentration are required more than in any other type of training. In a mixed training session, therefore skill training should ideally come immediately after the warm-up. It should not follow on from any I vigorous strength, power, endurance or cardiovascular training because the neuromuscular fatigue will prevent quality work (Bompa, 1994).

Adopting a ‘little and often’ approach to motor skill development is the best approach as long, drawn-out skill sessions lead to a quick deterioration in concentration and technique.

Feedback


A further consideration for skill training is that the client will need regular feedback so they know if they are performing the exercise correctly. This can be positive (telling them what they are doing well so they keep doing it) or negative (correcting errors in a constructive way).

Feedback can be from the personal trainer observing and giving verbal feedback, from self-observation using mirrors or video and from the client's own kinaesthetic sense (did the movement ‘feel’ right?). Most people do not like to be told what to do by someone else, or have someone else constantly pointing out their mistakes. An excellent technique for the personal trainer to master is to teach the client to self-evaluate. This can be done by questioning how the movement felt, asking the client what they noticed about specific aspects of the movement and using questions that encourage the client to think for him or herself. The personal trainer should ask important questions and encourage the client to establish their own answer (some probing questions and prompts can be offered. The trainer should not ask questions that they are aware the client will not know).

Visualisation

Scientists have discovered that simply visualising a movement in your mind's eye can be a very useful way to learn how to do the movement in reality. A strong visual image of a movement being performed appears to send nerve impulses along the same pathways in the central nervous system as if actually performing the movement. This encourages the new nerve connections to develop.

Equipment for motor skills training

Equipment may be used to enhance motor skills training and to add fun and variety to the workout. Specific exercises using each piece of equipment are explored further in the sports conditioning unit.

The following equipment can be easily obtained and applied to both general and specific motor skills training:

Stability discs These are partially inflated rubber discs that the participant stands, sits or rests their hands on (as in a press-up) to simulate an unstable surface. Essentially, they make it harder for the participant to balance and can be incorporated into skills training in a variety of ways.

Wobble board This is a circular board, about 40cm in diameter, with a half—ball underneath it. When stood upon, it wobbles unless balanced perfectly on the half-ball. It, too, simulates an unstable surface and trains balance. A wobble board is usually more of a challenge than a stability disc.

Swiss balls The use of Swiss balls is covered extensively. They simulate an unstable surface, and therefore the main motor skill they challenge is balance.

Bosu® A bosu is designed in the shape of half a Swiss ball resting on a flat board. it can be used with the flat side up (ball side balanced on the floor) or the flat side down (ball side in the air). A range of exercises can be performed using a bosu that will challenge balance.


Progressing motor skills training

Motor skills training can be progressed by using a variety of simple techniques.

A key consideration for the personal trainer is that each client will progress at their own pace. The difficulty of the skill should not be increased until the initial level has been mastered.

Initial training As skills improve

Slow movements Speed up to real-time pace

Simple movements Combine into more complex movements

Relaxed movement More competitive environment

No distractions Introduce distractions

Predictable drills Introduce random factors

Little accuracy required Increase accuracy expected

Stable base of support Destabilise base of support


Core stability training

The term ‘core stability’ training has become widely used in the fitness industry and is considered an important part of an effective training programme. There is no common agreement on exactly what ‘core stability’ is or the best methods to improve it. Furthermore, some health professionals (physiotherapists and chiropractors) suggest that the term is misrepresented and misunderstood.

With these issues in mind, this section introduces basic stability concepts and illustrates exercises that are generally accepted as being effective. Where a debate between researchers is on-going, both sides of the argument are presented and further reference sources are cited.

In the ‘Anatomy and physiology for exercise and health’ manual core stability and posture are discussed. It is worth familiarising yourself with this chapter before reading this section, as it details the role of the core muscles, ligaments, thoracolumbar fascia and intra-abdominal pressure.

Training to improve core stability

Neutral lumbar spine

An important part of core stability training is awareness of what a neutral lumbar spine position is and the ability to maintain that position while the legs and arms are performing various movements.

A neutral lumbar spine is roughly defined as halfway between a flat lower back (pelvis tilted fully backwards) and an arched lower back (pelvis tilted fully forwards). In addition, there should be no lateral flexion of the spine. Realistically, neutral spine is not one exact position, but a narrow zone in the middle of the range of movement, where there is neither excessive flexion nor extension, and the intervertebral discs experience an even distribution of pressure. This is referred to as the ‘neutral zone’. It is also important to remember that there is a lot of individual variation in the degree of natural lumbar curve.

Locating neutral zone - standing

To locate the neutral zone, clients can be advised to adopt a correct standing posture and, while maintaining this, to roll the pelvis forwards and backwards through the full range of movement to find a neutral or mid position between the two extreme points.

Standing with the shoulder blades, buttocks and heels touching a wall, most people are able to fit just their fingers between the wall and the small of their back when they hold a neutral spine.

If there is no gap at all, then there is too little arch (flat back posture), and if the whole hand fits between the wall and the back, there is probably too much arch (lordotic posture). Personal trainers should always be aware of individual client variation.

Locating neutral zone - lying


To locate the neutral zone, clients can be advised to adopt a supine lying position and move between pressing each of the vertebrae into the mat to flatten the natural lumbar curve and then arching the back in the opposite direction to create an exaggerated curve in the spine. They should then be advised to find a point about halfway between the two positions. Generally, they will be able to place the fingers into the gap between the floor and the spine. Once again, the personal trainer will need to be aware of individual differences and these must be borne in mind.

Locating and contracting the transverse abdominis (TVA)

To maintain a stable, neutral spine position, it may help if the TVA is contracted. This is because of the support obtained from intra—abdominal pressure and the thoracolumbar fascia (discussed earlier in this section).

The TVA can be located and contracted as follows:

• Place the hands just above the pelvis and cough. The muscle you feel contracting is the TVA

• Visualise a line drawn from each side of the pelvis — the right and left anterior, superiorljliabc spine (ASIS) and just below the belly button. When the TVA contracts, this area below the be y U On should pull upwards and inwards, flattening the abdomen.

• Place the hands just below the belly button and contract the TVA, simultaneously pulling up and contracting the pelvic floor. You should feel your lower abdomen flatten.

• Hold this contraction while maintaining a neutral spine position and breathe normally.

*N.B. It is actually quite difficult to contract the TVA in isolation, and that other abdominal wall muscles will usually be involved when following the above instructions. It is also difficult for the client or personal trainer to tell whether the TVA is actually being engaged or not, because of its deep position.

There are several ways to train and progress TVA engagement, which will be covered later in this section.

The debate about engaging the TVA

‘Pull in the abdominals’ or ’engage the TVA’ have now become virtually compulsory phrases for many group exercise trainers and personal trainers. Yet 10 years ago, the TVA was largely unheard of by trainers. So one may wonder why there has been such a change.

Most of the interest in the role of the TVA (and, to some extent, multifidus) is based on research that found faulty recruitment in these muscles in patients with lower back injury (Richardson et al, 1999). When these patients performed rapid arm movements, it was discovered that there was a delayed recruitment of the TVA by the nervous system compared to subjects with no back pain. It was hypothesised that this faulty recruitment contributed to reduced spine stability, and that retraining these muscles to contract correctly would improve lower back stability and reduce symptoms of pain. Following this research, interest in TVA and multifidus recruitment spread and has been applied universally to training core stability. The justification for the 'general' adoption of this is debatable.


The original research in this area was conducted on patients who already had a back injury. Injury causes pain, and pain is known to inhibit the recruitment and action of muscles, presumably as a natural protective mechanism. However, it cannot be implied from this with any certainty that weakness in the TVA or multifidus caused the back problems in the first place. Nor can it be implied that healthy clients, with no back pain, need to consciously contract their TVA to improve spine stability. The contraction necessary to stabilise the spine should occur as a natural recruitment pattern and happen unconsciously (Scott, 2006).

It is worth restating at this point that the original research into TVA dysfunction found that delayed recruitment was the problem, not reduced strength of the muscle. Simply pulling in the abdominals, or performing exercises such as the plank, to strengthen the TVA, will not change the timing of recruitment Indeed, it could be argued that conscious recruitment in such exercises is more likely to hinder the correct natural recruitment pattern, rather than to enhance it.

Conscious engagement of the TVA and multifidus has been misinterpreted and applied too universally In healthy clients it is probably unnecessary because the nervous system will naturally recruit stabiliser ‘ muscles at the correct speed as required. It is difficult for clients and personal trainers alike to tell if the TVA is actually the muscle being engaged, or whether other abdominal wall muscles are involved instead.

For clients with a history of back problems, TVA and multifidus engagement is recommended, but this is best left to a physiotherapist rather than to a personal trainer. This is because it is the timing of the contraction that is important, not the strength of the muscles, and specific low-load exercises are indicated. Having said this, conscious engagement of the abdominal wall is unlikely to cause harm.

Core stability training guidelines

• Always carry out a pre-exercise screening and only advise apparently healthy clients.

• Clients with existing back pain or structural problems such as scoliosis, should be referred to an appropriate professional.

• Aim to perform a variety of exercises to work all of the core stabiliser muscles in good balance.

• Perform both static (isometric) and dynamic exercises, because the core should be able to stabilise under a variety of loading conditions.

• When performing static (isometric) exercises for the core, the lumbar spine should be held in the neutral zone. Dynamic exercises should be performed in a slow and controlled manner, within the normal range of movement of the vertebral column, without any accessory movements elsewhere.

• Consciously engaging the TVA is probably unnecessary in healthy clients, but unlikely to cause harm.

• Exercises should initially be performed with low load, to emphasise correct neuromuscular recruitment. They can then be progressed gradually. Progression can be achieved by:

• reducing the base of support - eg, starting with a wide stance, then narrowing the stance, then using a single leg

• changing the surface - eg, progressing from the floor, to a mat, to a stability disc, to a Swiss ball


• adding movement - eg, attempting to move arms and legs while holding the core fixed will increase the challenge to stabiliser muscles

• reducing the support of body weight - eg, in the box position, taking away the support of an arm and leg (reciprocal reach) will increase the challenge to the core stabiliser muscles

• For heavily loaded movements, such as squats and deadlifts, abdominal bracing, combined with brief breath holding, is recommended.

Traditional resistance training exercises and the core

Many traditional resistance training exercises place great demands on core strength and are an excellent way to develop muscles in the trunk area. The most obvious examples are deadlifts and squats. Both engage a strong isometric contraction of erector spinae and other core stabilisers to prevent forward flexion of the spine while the weight is lifted. Both exercises are also closely related to everyday functions, such as lifting shopping or standing up from a chair.

Some individuals with a dysfunction in the associated muscles may need to improve the specific dysfunction under the supervision of a physiotherapist before attempting these exercises, in order to avoid learning incorrect movement patterns and exacerbating their dysfunction.

Some other examples of resistance exercises that directly train the core include:

• A triceps pushdown demands a strong isometric contraction of rectus abdominis to keep the trunk in place.

• A bent-over barbell row engages the spine stabiliser muscles isometrically.

• A standing shoulder press requires excellent stability throughout the full length of the spine; otherwise, the body would simply buckle under the weight.

• Any pressing or rowing exercise performed on a cable machine will require stabilisation throughout the legs and trunk from the ground upwards.


Part 4 - Programming

Principles of training

In essence, devising an effective programme for a client involves bringing together the results of Part two ‘Know your client’; with the available approaches from Part three ‘Approaches to training’. Once a picture of the client has been built, their goals can be matched up with available approaches and environments in order to put together a suitable programme. Inevitably, this will involve prioritisation and compromises, as there will be tensions between conflicting elements.

The diagram below demonstrates how the process might appear - the elements around the outside must be juggled in order to lead to the client programme in the centre.


Cardiovascularapproaches

Core stability and postural

approaches

Client support networks

Available environments

Results from fitness tests

Resistance approaches

Flexibility approaches

Client goals

Client barriers

Client injury and exercise history

Clients likes and dislikes

Client programme

Goal setting

It takes time and effort to establish an effective goal. Personal trainers should acquire the habit of asking key questions and eliciting quality information from the client. First, it must be possible to quantify (measure) the goal; otherwise it is not possible to tell when the goal has been achieved. Secondly, the goal must be specific. This usually involves stating numbers, such as a particular body weight to be reached, or an upper arm circumference to be achieved. Next, there must be a timeframe within which the goal is to be achieved. This usually involves setting a date, such as a holiday, wedding, sporting event an so on.

The acronym SMART is useful in this respect. A goal should be:

Specific

Measurable

Achievable /Agreed

Realistic

Time framed

The 'achievable' and ‘realistic’ components of SMART are often quite subjective and are influenced by factors such as client motivation, injury and unforeseen circumstances. Personal trainers can use their knowledge and experience to make reasonable estimates about what a client has the potential to achieve within a certain timeframe. For instance, it would be unachievable and unrealistic for a person with a naturally endomorphic body type to develop a size zero frame.

A typical example of a poorly stated goal, often seen on client programme cards, is: ‘Would like to build up my chest and arm muscles?’ If we analyse this statement, we see that it is:

• not specific (how much muscle does the client wish to build?)

• there is no thought as to how this extra muscle will be measured

• there is no timeframe set (when will the larger chest and arms be achieved?)

This goal could be made SMART by restating: ‘to add 2cm to chest circumference and 1cm to upper arm circumference in three months’.

Once the long term goal has been decided, it can be broken down into medium and short term goals. This leads us into some essential periodisation terminology: macrocycles, mesocycles and microcycles.

Macrocycle (long term goal)

The macrocycle refers to a long block of training that aims to accomplish the overarching goal, such as adding 2cm to the chest circumference, or achieving a certain body weight.

The recreational trainer may set a modest macrocycle of a few months. An athlete's macrocycle may cover a period of 12 months (relating to a competitive season) and an Olympian may plan a macrocycle lasting four years or beyond. Performance Training Academy 100

The macrocycle is then divided into smaller phases of training called mesocycles.

Mesocycle (medium term goal)

Each mesocycle will emphasise a particular medium term goal, such as muscular endurance, aerobic fitness, fat loss or active rest. The mesocycles represent steps along the way towards the long term goal.

Each mesocycle is then divided into smaller phases of training called microcycles.

Microcycle (short-term goal)

A typical microcycle refers to one week of training. Each microcycle will have its own specific training aim that contributes to the medium and long term goals. This is where the client and trainer decide on detailed content of each individual training session.

Modern ideas about periodisation began in Eastern Europe, where it was used as a method of optimising performance and recovery with weight lifters and field athletes. The application of these training patterns has now been shown to be beneficial for recreational training goals, as well as for elite performers.

In this section, we provide an overview of the research that supports periodised programming and offer examples for practical application with clients. Hans Selye (1956), a prominent endocrinologist, first proposed the principles that underpin the concept of periodisation. Selye suggested that the human body goes through three stages when presented with any form of stress, such as that imposed by intense training.

General adaptation syndrome

Stage 1: Shock This represents the response to the initial training stimulus, where fatigue and soreness result in a decrease to performance as the body attempts to recover from the stresses imposed upon it.

Stage 2: Adaptation The body adapts physiologically (overcompensation) to the training stimulus and performance increases. This phase results in greater strength, endurance, muscular hypertrophy or CV fitness, according to the stimulus imposed.

Stage 3: Staleness Once the body has adapted, no further adaptations will take place until a new stimulus is introduced (the next training session), and a training plateau will occur unless the new session is different in some respect from the last one.

Training plateaus naturally limit progress, and they are inevitable unless the programme is varied on a regular basis to present a new stimulus. This is the basis for periodisation.

Periodisation is a long term training plan that changes the workouts at regular intervals by manipulating volume, intensity and type of exercises.


Benefits of periodised programmes

The main benefits of adopting a periodised training approach are:

• ensuring continued physiological and anatomical gains by avoiding training plateaus

• ensuring regular rest and recovery (which is just as important as the actual training for achieving fitness gains)

• ensuring that peak fitness is achieved to coincide with major events and competitions

• preventing the training schedule from becoming boring

• prevention of overtraining syndrome

• prevention of overuse injuries.

Basic principles of periodisation

Volume and intensity

These are the two main variables that are manipulated in a periodised programme.

Volume - refers to the quantity of training done during a given period and can be measured in:

• distance (miles per week) •• time (hours per week) •• total resistance lifted (exercises x sets x repetitions x resistance)

For instance, the total distance run in a single session ie, 10 intervals of 200m equates to a training volume of 2000m.

Intensity - refers to the degree of difficulty of the training. In CV training, intensity is described as a percentage of maximum heart rate, or RPE. In resistance training, intensity relates to the weight of the resistance (how heavy the weight is).


Periodisation

In general, the first mesocyclone contains a high volume of low intensity training, and subsequent mesocycles gradually reduce the volume whilst at the same time increasing the intensity of training, although, to some extent, it depends upon the goal of the client.

The basic principles of periodisation are summarised in the following diagram:


Present state Goal

Macrocycle

Mesocycles 1st 2nd 3rd 4th

Microcycles

Volume

Intensity

Step loading

A second model of periodisation that is relatively easy to implement is known as step-loading.

Step-loading refers to a progressive variation in the training stimulus typically over a four week cycle. The first three weeks of the cycle become gradually more intense. The fourth week is then characterised by a dramatic drop in training load to allow for adequate recovery.

Examples of CV step-loading and RT step-loading are shown in the following tables.

The whole four weekly cycle would then begin over again, but each step would be at a slightly higher intensity than in the previous cycle. In this way, long term progression in fitness is achieved.


Step-loading a CV programme

Week 1 Moderate intensity training (55-70% max HR)

Week 2 Vigorous intensity training (70-85% max HR)

Week 3 High intensity training (more than 85% max HR)

Week 4 Recovery (light daily activities)

Step-loading a RT programme

Week 1 EnduranceLow resistance/high reps (15RM)

Week 2 HypertrophyModerate resistance/moderate reps (8-12 1RM)

Week 3 StrengthHigh resistance/low reps (4-6RM)

Week 4 Recovery (light daily activities)

Weekly periodisation

This refers to the variations of training within a one week cycle, sometimes referred to as ’non-linear’ periodisation. The basic rule is that a high intensity training day is followed by a low to moderate training day or complete rest.

For example, a client who runs for recreation might periodise their training with a tempo session on Monday, a fartlek session on Wednesday and a long-slow-distance training (LSDT) session on the Friday. Notice in the following example provided the high-intensity training period is preceded by two days of rest (Saturday and Sunday).

A resistance training programme might be periodised over one week as follows:

Four-weekly (monthly) and weekly periodisation models are generally more suitable to the recreational trainer than the yearly model. Most clients do not have the time or desire to commit to a fitness goal in a year's time. Shorter time frames are often more manageable for a busy lifestyle and are more motivating, as achievements arrive sooner.

Developing a periodised programme

The development of a periodised programme requires that the personal trainer determines and organises a client's goals and training objectives in a systematic and progressive manner. Sleamaker (1989) recommends the following six steps for constructing a periodised programme: .

• Events and competitions

• Performance goals

• Physical preparation

• Psychological preparation

CV periodisation within a weekly cycle

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

High intensity, low volume (eg, tempo)

Rest Moderate intensity, moderate volume (eg, fartlek)

Rest Low intensity, high volume (eg, LSDT)

Rest Rest

RT periodisation within a weekly cycle

Monday Wednesday Friday

Sets 3-4 4-5 3-4

Repetitions 8-10RM 3-5RM 12-15RM

Rest interval 2 minutes 3-4 minutes 1 minute


• Technical preparation

• Tests and standards

Using these six steps, an example programme for a recreational runner who wants to run a 10K in six months might look something like the following:

• Events and competitions: to run 10K in six months.

• Performance goals: previous 10K was nine months ago, time was 41:12. Want to break 40 minutes in six months.

• Physical preparation: develop aerobic endurance and improve anaerobic threshold.

• Psychological preparation: identify performance anxieties or stressors and develop coping responses.

• Technical preparation: work on developing an efficient stride length and a relaxed running action.

•• Tests and standards: VO2max = 52ml/kg/min. Use 10km time trials to act as performance

indicators for the 40 minute goal.

The periodised programme for this runner might include 12 weeks in the base phase to develop aerobic capacity. The volume is progressively increased over the 12 weeks from six hours to 18 hours, but at a low intensity. The preparation phase is eight weeks in duration, focusing on improving anaerobic threshold at a vigorous intensity, but the volume is reduced to nearly 50% (nine hours). The competition phase is four weeks in duration with the emphasis on speed work and high intensity training for three weeks. The volume is further reduced to six hours. In the final week the high intensity work is decreased to prepare for the event.

Periodisation and health-related fitness

Periodisation is not a necessity for health related fitness; however, because physiological adaptation follows the model outlined by Selye, it is logical to suggest that long term training programmes for health related fitness would be more effective if planned in specific phases (or cycles).

The following table gives an example of how a periodised programme might look for a client just wanting to improve their health related fitness.

A Level 3 personal trainer needs to have a good understanding of periodised programming. With the wide variety of clients’ a personal trainer may come into contact with it is essential the personal trainer remains up to date and knowledgeable in this area. If a client has a particular

Macrocycle

Mesocycle ‘Getting started’ ‘Improving’ ‘Maintaining’

Specific goals To establish a positive new exercise habit

To gradually increase duration and intensity until ACSM minimum guidelines are attained

To maintain long-term adherence by using varied and enjoyable training


sport they are training competitively for then it is essential that the personal trainer carries out CPD in areas where they need to add to their knowledge. A strength and conditioning course or sports conditioning module may be a good starting point for an enhanced understanding of effective periodisation for sport (competitive or recreational).


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