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indicationsanddosageandforaddedwarningsandprecautions.Thisis particularlyimportantwhentherecommendedagentisaneworinfrequently employeddrug.

SomedrugsandmedicaldevicespresentedinthispublicationhaveFoodand DrugAdministration(FDA)clearanceforlimiteduseinrestrictedresearch settings.Itistheresponsibilityofthehealthcareprovidertoascertainthe FDAstatusofeachdrugordeviceplannedforuseintheirclinicalpractice.

Preface

AdditionalResources

Thisfiftheditionof ACSM’s Resources for the Personal Trainer represents anotherstepforwardfromthepreviouseditionandisbasedon ACSM’s Guidelines for Exercise Testing and Prescription, 10th edition.Inthisfifth edition,theeditorsandcontributorshavecontinuedtorespondtotheneedsof practicingPersonalTrainers.Thiseditionhasexpandeduponthefourth editioninthatcontentwasupdatedwiththelatestscientificevidence, preparticipationscreeningrecommendationswererevisedtoreflectnew guidelinesforparticipatinginphysicalactivity,andanewchapteron functionalmovementwasadded.

Overview

ACSM’s Resources for the Personal Trainer, 5th edition,continuesto recognizethePersonalTrainerasaprofessionalinthecontinuumofcreating healthylifestyles.ThistextprovidesthePersonalTrainerwithboththetools andscientificevidencetohelpbuildsafeandeffectiveexerciseprogramsfor avarietyofclients.Thebookisdividedintosixdistinctlydifferentparts, rangingfromanintroductiontotheprofessionofpersonaltrainingto considerationsofhowtorunyourownbusiness.Inbetweenarechapters dedicatedtothefoundationsofexercisesciencewhichincludeanatomy, exercisephysiology,biomechanics,behaviormodification,andnutrition.The science-andevidence-basedapproachprovidesawayforthetransferof knowledgefromthePersonalTrainertotheclient,allowingforthe opportunityforsuccessfromabusinessstandpoint,aswellasforthe

individualclients.Themiddlechaptersincludeestablishinggoalsand objectivesforclientsanda“how-to”manualforpreparticipationscreening guidelinesaswellasassessingbodycomposition,cardiovascularfitness, muscularfitness,andflexibility.Thelastsectionsofchaptersarededicatedto developingvarioustrainingprograms,addressingspecialpopulationsand advancedtrainingprogramoptions,andprovidingthebasicsonbusinessand legalconcernsfacingPersonalTrainers.

Organization

Thechaptersaredividedintosixpartsdesignedforeaseofnavigation throughoutthetext.Usingthisapproach,usefulnesswillbemaximizedfor everyPersonalTrainer.

PartI:IntroductiontotheFieldandProfessionofPersonalTraining.

Twointroductorychaptersaredesignedtointroducethenewandaspiring PersonalTrainertotheprofession.Chapter1providesinsightintowhythe healthandfitnessprofessionsaresomeofthefastestgrowingindustriesin theworldandhowthePersonalTrainercancapitalizeonthisgrowth. Chapter2providesacareertrackforthePersonalTrainer,helping prospectivePersonalTrainerstoexaminetheirowninterestinpersonal trainingandhowtomakepersonaltrainingaviablecareer.

PartII:TheScienceofPersonalTraining.

InPartII,Chapters3–6provide thescientificfoundationsforpersonaltraining.EveryPersonalTrainer, regardlessofexperience,willfindthesechaptershelpful.ForthePersonal Trainerjuststartingout,thesechaptersintroducethescientificbasisfor physicalactivity.FortheadvancedPersonalTrainer,thesechaptersserveasa foundationalresourceforspecificlifestylemodificationprograms.Thesefour chaptersincludeanatomyandkinesiology,appliedbiomechanics,exercise physiology,andnutrition.

PartIII:BehaviorModification.

Thenextsectionofthisbookisdedicated tolearninghowandwhypeopleareeitherwillingorunwillingtochange theirbehavior.Oneofthemostfrustratingaspectsofpersonaltrainingis

whenaclientrefusestochangeadeleterioushabitoreven“cheats”between trainingsessions.Chapters7–9includediscussionsoftheconceptof “coaching” anewwayoflookingatandcreatingyourrelationshipwitha client.Thesechapterswillforeverchangeyourapproachtopersonaltraining.

PartIV:InitialClientScreening.PartIVcomprisesChapters10,11,and 12andwalksthePersonalTrainerthroughthefirstclientmeetingtoa comprehensivehealth-relatedphysicalfitnessassessment.Capitalizingonthe learningobjectivesofPartIII,thissectionestablishesaframeworkfor developingclient-centeredgoalsandobjectives.Thoughcertainlynotan exhaustivelistofphysicalfitnessassessments,Chapter12providescritical techniquestoevaluateaclientbothinthefieldandinthelaboratory.This sectionincludesmanytables,figures,andcasestudiesthatwillassistwith placingclientsintovariousfitnesscategories.

PartV:DevelopingtheExerciseProgram.

Chapter13introducesthe conceptofdevelopingacomprehensiveexerciseprogram.Onthebasisofthe goalsestablishedbytheclientandthePersonalTrainer,Chapters14–16 (resistancetraining,cardiorespiratory,andflexibilityprograms,respectively) arespecific“how-to”manuals.Newtothisbook,Chapter17presents informationregardingfunctionalmovementassessmentsandprogramming. Chapter18isdedicatedtothepropersequencingofexerciseswithinagiven personaltrainingsession,whereasChapter19hasbeenwrittenforthe PersonalTrainerwhoworkswithindividualswhodesiremoreadvanced trainingoptions.Finally,Chapter20providesexpandedcoverageabout workingwithclientswithspecialhealthormedicalconditions.Asmore peopledecidethatbeingactiveisagoodthing,PersonalTrainerswill encounterthesespecialpopulations.Thischapteralsodiscussesthescopeof aPersonalTrainer’sknowledge,skills,andabilitieswhenitcomesto workingwiththese“specialpopulations.”

PartVI:TheBusinessofPersonalTraining.Althoughseeingclients improveisrewarding,onegoalofasuccessfulbusinessistobeprofitable financially.Chapters21and22introducetheprofessionalPersonalTrainerto commonbusinesspracticesandprovideinformationabouthowtoavoid

someofthecommonmistakesbeginnerstypicallymakeinthedevelopment oftheirpractices.Chapter22dealsspecificallywithlegalissues.Writtenbya practicingattorneywithyearsofexperiencelitigatingcourtcases,this chapterencourageseachPersonalTrainertotaketheirresponsibility seriouslybygettingthenecessarytrainingandexperience.

Features

SpecificelementswithinthechapterswillappealtothePersonalTrainer.A listofobjectivesprecedeseachchapter.Keypointshighlightimportant conceptsaddressedinthetextandboxesexpandonmaterialpresented.Case Studiespresentcommonscenariosthatallowforapplicationofconcepts coveredwithinthechapters.Iconsareprovidedinselectedchaptersdirecting thereadertovaluablevideosfoundatthepoint.lww.com/ACSMRPT5e. Numerousfour-colortables,figures,andphotographswillhelpthePersonal Trainerunderstandthewrittenmaterial.Achaptersummaryconcisely wrapsupthecontent,andreferencesareprovidedattheconclusionofeach chapterforeasyaccesstotheevidence.

AdditionalResources

ACSM’s Resources for the Personal Trainer, Fifth Edition,includes additionalresourcesforstudentsandinstructorsthatareavailableonthe book’scompanionwebsiteathttp://thepoint.lww.com/activate.Seetheinside frontcoverofthistextformoredetails,includingthepasscodeyouwillneed togainaccesstothewebsite.Anyupdatesmadeinthiseditionofthebook priortothepublicationofthenexteditioncanbeaccessedat http://certification.acsm.org/updates.

Students

Videoclips

Instructors

Approvedadoptinginstructorswillbegivenaccesstothefollowing

additionalresources:

Brownstonetestgenerator

PowerPointpresentations

Imagebank

Lessonplans

Moodle/Angel/Blackboard-readycartridges

Acknowledgments

Thefiftheditionof ACSM’s Resources for the Personal Trainer continuesto buildonpreviouseditionstomakeitanall-encompassingresourcefor PersonalTrainers.Aswiththepreviouseditionsofthistext,withoutthe manyvolunteercontributorswhowrotethechapters,thistextwouldnotbe theresourceithasbecome.Additionally,theeditorswouldliketothankthe manydedicatedreviewerswhoalsovolunteeredtheirtimetocarefullyreview eachchaptertoensurethecontentwascurrentandestablishedguidelines wereaccuratelypresented.Thistextisatrueteameffortofvolunteereditors, contributors,andreviewers.

ThankyoutothestaffattheAmericanCollegeofSportsMedicine (ACSM),specificallytheEditorialServices,Publications,andMarketing departmentsfortheirsupportandassistance.ThestaffatACSMwork tirelesslytomakeprojectslikethishappenandensureconsistencyamongall ACSM-relatedpublications.

Personally,IwouldliketothankAngieChastainandKatieFeltmanfor theunderstanding,constantsupport,andencouragementtheyhaveprovided forthepast3years,thisyearinparticular.Thankyoutotheassociateeditors thatcontributedhoursoftheirtimetoimprovingthisedition.

Andlast,butcertainlynotleast,thankyoutothemanydedicatedPersonal Trainersthatmakethisworksorewarding.Wewishyoucontinuedsuccessin acareerthathassuchadirectinfluenceonthehealthofothers.

Contributors*

BrentA.Alvar,PhD,FACSM

RockyMountainUniversityofHealthProfessions

Provo,Utah

Chapter 14

DanBenardot,PhD,DHC,RD,FACSM

GeorgiaStateUniversity

Atlanta,Georgia

Chapter 6

BarbaraA.Bushman,PhD,FACSM,ACSMPD,ACSMCEP,ACSM

EP-C,ACSMCPT

MissouriStateUniversity

Springfield,Missouri

Chapter 13

KathyCampbell,EdD,FACSM

ArizonaStateUniversity

Phoenix,Arizona

Chapter 15

MarissaE.Carraway,PhD

EastCarolinaUniversity

Greenville,NorthCarolina

Chapter 7

CarolN.Cole,MS,ACSMHFD,ACSMEIM2

SinclairCommunityCollege

Dayton,Ohio

Chapter 21

LanceDalleck,PhD

TheUniversityofAuckland

Auckland,NewZealand

Chapter 20

EmilyK.DiNatale,PhD

SinclairCommunityCollege

Dayton,Ohio

Chapter 7

DanaeDinkel,PhD

UniversityofNebraskaMedicalCenter

Omaha,Nebraska

Chapter 8

AylaDonlin,EdD,ACSMCPT,ACSMEIM1

CaliforniaStateUniversity,LongBeach

LongBeach,California

Chapter 16

JulieJ.Downing,PhD,FACSM,ACSMHFD,ACSMCPT

CentralOregonCommunityCollege

Bend,Oregon

Chapter 1

GregoryDwyer,PhD,FACSM,ACSMPD,ACSMRCEP,ACSMCEP, ACSMETT,ACSMEIM3

EastStroudsburgUniversity

EastStroudsburg,Pennsylvania

Chapter 11

DianeEhlers,PhD

UniversityofIllinoisatUrbanaChampaign

Urbana,Illinois

Chapter 8

YuriFeito,PhD,MPH,ACSMRCEP,ACSMCEP

KennesawStateUniversity

Kennesaw,Georgia

Chapter 5

BrianGoslin,PhD

OaklandUniversity

Rochester,Michigan

Chapter 5

AnitaM.Gust,PhD

ConcordiaCollege

Moorhead,Minnesota

Chapter 1

TrentHargens,PhD,FACSM,ACSMCEP,ACSMEIM3

JamesMadisonUniversity

Harrisonburg,Virginia

Chapter 12

AndyHayes,MS

AtlasFitnessEvolved,LLC

St.Louis,Missouri

Chapter 13

JenniferHuberty,PhD

ArizonaStateUniversity

Phoenix,Arizona

Chapter 8

JeffreyM.Janot,PhD

UniversityofWisconsin-EauClaire

EauClaire,Wisconsin

Chapter 20

AlexandraJurasin,MS

PlusOne/Optum

SanFrancisco,California

Chapter 10

NiColeR.Keith,PhD,FACSM

IndianaUniversity-PurdueUniversityIndianapolis Indianapolis,Indiana

Chapter 9

JimLewis,PT,DPT,ATC

BrenauUniversity

Gainesville,Georgia

Chapter 3

LesleyLutes,PhD

EastCarolinaUniversity

Greenville,NorthCarolina

Chapter 7

PeterMagyari,PhD,FACSM,ACSMEP-C UniversityofNorthFlorida

Jacksonville,Florida

Chapter 11

MikeMotta,MS

NetPositiveCoaching

NewYork,NewYork

Chapter 2

NicoleNelson,MHS,LMT,ACSMEP-C

UniversityofNorthFlorida

Jacksonville,Florida

Chapter 17

NicholasRatamess,Jr.,PhD

TheCollegeofNewJersey

Ewing,NewJersey

Chapter 19

JanSchroeder,PhD

CaliforniaStateUniversity,LongBeach

LongBeach,California

Chapter 16

DeonL.Thompson,PhD,ACSMPD

GeorgiaStateUniversity

Atlanta,Georgia

Chapter 3

WalterR.Thompson,PhD,FACSM,ACSMPD,ACSMRCEP

GeorgiaStateUniversity

Atlanta,Georgia

Chapter 6

JacquelynWesson,JD,RN

Wesson&Wesson,LLC

Warrior,Alabama

Chapter 22

MissouriStateUniversity

Springfield,Missouri

Chapter 4

MaryYoke,MA,FACSM

IndianaUniversity

Bloomington,Indiana

Chapter 18

*SeeAppendixBforalistofcontributorsfortheprevioustwoeditions

Reviewers

JessicaN.Ascenzo,ACSMCPT GeorgiaGwinnettCollege

Alpharetta,Georgia

LorieBeardsley-Heyn,ACSMCPT TrainingMadePersonal Milan,Michigan

NicholasA.Burke,ACSMCPT BurkeFitness,LLC Columbus,Ohio

DanielP.Connaughton,EdD,ACSMEP-C UniversityofFlorida

Gainesville,Florida

MichaelHemmer,ACSMCPT

MetroHealth’sAamothFamilyPediatricWellnessCenter Cleveland,Ohio

JonathanT.Keown,ACSMCPT UniversityofSouthCarolina Columbia,SouthCarolina

DeniseMurray,ACSMCPT,ACSMEP-C EcoPlexus,Inc.

LakeOrian,Michigan

ColleenE.Oakes,ACSMCPT

IvyRehabPhysicalTherapy

HighlandPark,Illinois

JanetT.Peterson,DrPH,FACSM,ACSMEP-C,ACSMRCEP

LinfieldCollege

McMinnville,Oregon

AmyJoSutterluety,PhD,FACSM,ACSMCEP,ACSMEIM3

Baldwin-WallaceCollege Berea,Ohio

JessicaTax,ACSMCPT,ACSM/ACSCET

MoveUpHealthandFitness

Sacramento,California

SaraL.Townley,ACSMCPT

NRHCentre

NorthRichlandHills,Texas

KristinA.Traskie,MPH,ACSMCPT

MichiganStateUniversity

EastLansing,Michigan

Introductionto theFieldand Professionof Personal Training

andProfessionof PersonalTraining

For additional ancillary materials related to this chapter, please visit thePoint.

OBJECTIVES

PersonalTrainersshouldbeableto:

RecognizetheneedforaPersonalTrainer. DescribethescopeofpracticeofaPersonal Trainer,includingthebackgroundand experienceneededtobecomeaPersonal Trainer.

Discussprofessionalcareerenvironments andothereducationalopportunitiesfor PersonalTrainers.

Identifyfuturetrendsthatwillaffectthe fitnessindustryandpersonaltraining.

INTRODUCTION

Personaltraining(practicedbyonereferredtointhisbookasthe “PersonalTrainer”butoftendescribedasa“fitnesstrainer,”“personal fitnesstrainer,”“fitnessprofessional,”or“weighttrainer”)continuesto beafastgrowingprofessionsintheUnitedStates.AccordingtotheU.S. DepartmentofLabor,BureauofLaborStatistics,thejoboutlookforthis professionisprojectedtogrow“fasterthantheaverage”forall occupationsbetween2014and2024,whichisfurtherdefinedasan increaseof8.4%duringthisdecade(6).Theincreasedemphasison healthandfitness,diverseclienteleinterestedinandinneedofhealthand fitness,andrecentlinksbetweensedentaryactivitiesandall-cause mortalityprovidemultipleopportunitiesforPersonalTrainers.

Considersomegroupsforwhompersonaltrainingmaybeof increasedinterest.Babyboomers(approximately78millionAmericans bornfrom1946to1964)arethefirstgenerationintheUnitedStatesthat grewupexercising,andtheyarenowreachingretirementage;theyhave thetimeanddesiretobeginorcontinueexercisingintheir70sand beyond(16).Lifeexpectancyhasalsoincreasedtoanaverageageof 79.68years(9).Inaddition,anincreasingnumberofbusinessesare recognizingthemanycost-relatedbenefitsthathealthandfitness programsprovidefortheiremployees(6).Therecentemphasisand relianceontechnologyintheofficeandhomehasledtoanincreased timespentinsedentary-typeactivities (e.g.,sittingandworkingata computer).Thisincreasedsedentarytimeisassociatedwithobesity, diabetes,andcardiovasculardisease(11).

Olderadultsandworkingadultsarenottheonlypotentialclientsfor PersonalTrainers.Agrowingconcernaboutchildhoodobesityandthe reductionofphysicaleducationprogramsinschoolswillalsocontribute totheincreaseddemandforfitnessprofessionals.PersonalTrainersare increasinglybeinghiredtoworkwithchildreninnonschoolsettings,such

ashealthandfitnessfacilities.Becauseoftheincreasedconcernfor fitness,thenumberofweight-trainingcentersforchildrenandhealthand fitnesscentermembershipamongyoungadultsisexpectedtocontinueto growsteadily(13,14).

TheFitnessIndustry:AnOverviewofthe Landscape

Interestingly,althoughthepopulationmaybemorephysicallyinactivethan ever,thehealthandfitnesscenterindustryhasneverbeeninbetter“shape.” ConsiderthefollowinginformationreportedbytheUnitedStatesfromthe InternationalHealth,RacquetandSportsclubAssociation(IHRSA),atrade associationservingthehealthandfitnessfacilitiesindustry(13)andtheU.S. DepartmentofLabor,BureauofLaborStatistics(6):

36,180 NumberofU.S.healthclubs

55.3 million NumberofU.S.healthclubmembers

$25.8 billion TotalU.S.fitnessindustryrevenuesfor2015

California,Texas,Florida,NewYork,andIllinoishavethemost fitnessclubs

22% Increaseintotalhealthclubmemberssince2009

279,100 NumberofU.S.fitnesstrainers/aerobicsinstructors

AccordingtotheU.S.DepartmentofLabor, BureauofLaborStatistics,thejoboutlookfor thisprofessionisprojectedtogrow“fasterthan theaverage”foralloccupationsbetween2014 and2024.

Althoughthesenumbersmayseemimpressive,considerhowmanypeople actuallyliveintheUnitedStatescomparedtothenumberthatarehealthclub members.Itislikelythatonly15%ofthepopulationhasamembershiptoa fitnesscenter.Althoughtherearecertainlyavarietyofavenuestoengagein physicalactivity,datasuggestadultsarenotmeetingtherecommendations forphysicalactivity.AccordingtotheCentersforDiseaseControland Prevention(CDC),24%ofadultsperformnoleisuretimeactivity(Fig.1.1) (7).Additionally,thesoutheasternpartoftheUnitedStatesnotonlyhaslow leisuretimeactivitybutalsoreportsthehighestratesofobesityanddiabetes (Figs.1.2and1.3).

FIGURE 1.1. 2008 Physical Activity Guidelines for Americans. (Adapted from Centers for Disease Control and Prevention. U.S. Physical Activity Statistics, 2007 [Internet]. Atlanta [GA]: Centers for Disease Control and Prevention; [cited 2012 May 21]. Available from: http://www.cdc.gov/nccdphp/dnpa/physical/stats/index.htm.)

FIGURE 1.2. Prevalence of obesity in percentage (body mass index ≥30) and diagnosed diabetes in the US adults in 2014 The data shown in these maps were collected through the CDC’s Behavioral Risk Factor Surveillance System (BRFSS) Each year, state health departments use standard procedures to collect data through a series of monthly telephone interviews with the US adults Prevalence estimates generated for the maps may vary slightly from those generated for the states by the BRFSS as slightly different analytic methods are used (From the Centers for Disease Control and Prevention U S LeisureTime Physical Inactivity by U S County 2008 [Internet] Atlanta [GA]: Centers for Disease Control and Prevention; [cited 2011 Mar 9] Availablefrom:http://wwwcdcgov/Features/dsPhysicalInactivity)

FIGURE1.3.Physicalinactivityestimates,bycounty,2014 Alargeproportionofthepopulationcouldbenefitfrominvolvementin sometypeofregularphysicalactivityaspartofahealthylifestyle,whetheras amemberofahealth/fitnessfacilityorontheirown.PersonalTrainersare

wellpositionedtoinfluencethegreaterscopeofpublichealthinthisregard. Asthehealthandfitnessfacilityindustrycontinuestogrow,sotoowillthe demandforhighlyqualifiedandcertifiedfitnessprofessionalstoservethe needsoftheirmembers(17).

Despitethegrowthofthefitnessindustryandemergingopportunitiesfor physicalfitness,highinactivityratesamongAmericansremain,withonly1 in5adultsmeetingtherecommendedamountsofphysicalactivityandfewer than3in10highschoolstudentsachieveatleast60minutesofphysical activityeveryday(7).Publicschoolscontinuetocutbackoreliminate physicaleducation.Infact,attheelementaryschoollevel,sixstatesrequire schoolstofollowthenationallyrecommended150minutesperweekof physicaleducation.Only16%ofstatesrequireelementaryschoolstoprovide dailyrecess.Formiddleschools/juniorhighs,onlythreestatesrequirethe recommended225minutesperweekofphysicaleducation(15).

Healthcarecostsarerisingexponentiallyasthemedicalfieldcontinuesto focusmoreontreatmentthanonprevention.Foodportionsizesinrestaurants areincreasing.AccordingtotheCDC,obesityhasbecomeaproblemin everystate.Nostatereportedthatlessthan20%ofadultswereobesein 2015.Thedataalsoshowthatatleast30%ofadultsin21statesandGuam wereobesein2015(seeFig.1.2).Thisisquiteachangefrom2000whenno statesreachedthatlevelofobesityandin2010when12stateswereatthat level.Thedataalsoindicatehowobesityimpactssomeregionsmorethan others.Forexample,statesintheSouthhavethehighestobesityrateat 31.2%,theMidwesthadanobesityrateof30.7%,theNortheasthadarateof 26.4%,andtheWesthadarateof25.2%(7,8).

Despitethegrowthofthefitnessindustryand emergingopportunitiesforphysicalfitness,high inactivityratesamongAmericanshavenotreally changedinthepast20years.

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