Assessor Resource

SISFFIT526A
Deliver prescribed exercise to clients with musculoskeletal conditions

Assessment tool

Version 1.0
Issue Date: April 2024


This unit applies to specialised exercise trainers, whose clients have been provided an exercise prescription from an accredited exercise physiologist or relevant medical or allied health professional.

The specialised exercise trainer applies the understanding and skills to deliver the program and modify the program in terms of frequency, mode, intensity and volume to accommodate the progression of the client within the parameters prescribed by the accredited exercise physiologist or relevant medical or allied health professional.

They apply self directed application of knowledge and skills related to musculoskeletal conditions, and exercise judgment in delivering the prescribed exercise. The specialised exercise trainer demonstrates the ability to analyse the clients responses to exercise and where appropriate consult with the accredited exercise physiologist or relevant medical or allied health professional.

This unit describes the performance outcomes, skills and knowledge to deliver prescribed exercise programs to stable clients with musculoskeletal conditions, in collaboration with medical or allied health professionals.

No licensing, regulatory or certification requirements apply to this unit at the time of endorsement.

You may want to include more information here about the target group and the purpose of the assessments (eg formative, summative, recognition)

Prerequisites

Nil


Employability Skills

This unit contains employability skills.




Evidence Required

List the assessment methods to be used and the context and resources required for assessment. Copy and paste the relevant sections from the evidence guide below and then re-write these in plain English.

The evidence guide provides advice on assessment and must be read in conjunction with the performance criteria, required skills and knowledge, range statement and the Assessment Guidelines for the Training Package.

Overview of assessment

Critical aspects for assessment and evidence required to demonstrate competency in this unit

Evidence of the following is essential:

communicates effectively with accredited exercise physiologist or relevant medical or allied health professional regarding health and functional status of the referred client

effective communication skills to discuss aspects of exercise prescription with clients

when appropriate, react to adverse events to deal with exercise program problems and issues

ability to correctly interpret the exercise prescription and make modifications consistent with prescribed parameters and scope of practice

safely and effectively delivers exercise for referred clients with musculoskeletal conditions and recommends appropriate alterations according to client's physical and motivational responses

monitors and maintains the safety of clients, exercise equipment and the exercise setting and applies effective contingency management techniques to deal with problems and issues that may arise during the exercise program

applies all relevant legal and ethical requirements when discussing and recording client information

demonstrates appropriate manner, empathy and patience when working with clients

Context of and specific resources for assessment

Assessment must ensure demonstration of skills over a period of time within a facility where a variety of exercise modes and equipment are available to support effective musculoskeletal exercise.

Assessment must also ensure access to:

facility where a variety of exercise modes and equipment are available, such as exercise machines, weight machines, exercise mats and adequate floor space

a range of clients with real or simulated musculoskeletal conditions from a range of ages

a range of real or simulated medical or allied health professionals referrals for a range of clients with musculoskeletal conditions and risk factors

demonstration of skills on sufficient occasions to determine competence in interpreting relevant information and delivering the prescribed exercise program for a range of clients with a range of musculoskeletal conditions

relevant documentation such as client record forms.

Method of assessment

A range of assessment methods should be used to assess practical skills and knowledge. The following examples are appropriate for this unit:

observation of consulting with clients and adjusting standard exercise prescriptions in consultation with an appropriate medical or allied health professional, to account for a range of musculoskeletal conditions and risk factors to focus on functional capacity and health rather than physical fitness

observation of dealing effectively with a range of contingencies such as real or simulated client injuries or inability to complete the exercise prescription

oral and or written questioning to assess knowledge of the physiology of musculoskeletal conditions, medications and associated risk factors

third-party reports from a supervisor detailing work performance.

Holistic assessment with other units relevant to the industry sector, workplace and job role is recommended, for example:

SISFFIT523A Deliver prescribed exercise to clients with cardiorespiratory conditions

Guidance information for assessment


Submission Requirements

List each assessment task's title, type (eg project, observation/demonstration, essay, assingnment, checklist) and due date here

Assessment task 1: [title]      Due date:

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Assessment Tasks

Copy and paste from the following data to produce each assessment task. Write these in plain English and spell out how, when and where the task is to be carried out, under what conditions, and what resources are needed. Include guidelines about how well the candidate has to perform a task for it to be judged satisfactory.

Required skills

communication skills to elicit and convey information to clients with musculoskeletal conditions to enable the delivery and modification of appropriate and effective exercise prescription

problem-solving skills to;

identify adverse signs and symptoms requiring intervention and

unsafe exercise performance

recommend appropriate changes in consultation with an appropriate medical or allied health professional

team work skills to work collaboratively with medical or allied health professionals according to legal and ethical considerations

analytical skills to interpret information on the health and functional status of clients with musculoskeletal conditions in terms of their medical conditions, risk factors, medical treatments and exercise history

decision making skills to determine appropriate instructional techniques

literacy skills to accurately document and report on client progress.

Required knowledge

anatomy of the musculoskeletal system and its supporting systems

function of the musculoskeletal systems to enable design of appropriate programs

the pathology of musculoskeletal conditions and considerations in relation to the conditions of the client

directional and movement terminology to enable effective communication with medical or allied health professionals

range of motion and stretching techniques to enable the inclusion of exercise variables to suit client's functional capacity

structural and physiological changes consistent with the pathology of disease states or conditions affecting the musculoskeletal system

risk factors and contraindications associated with musculoskeletal conditions to enable the provision, monitoring and adjustment of safe and effective exercise

effect of musculoskeletal conditions on the acute response to exercise to enable assessment of the individual's functional capacity when developing exercises

categories of medications used to manage musculoskeletal conditions such as nonsteroidal anti-inflammatory drugs (NSAIDs) and their effects on the condition

medical and anatomical terminology to interpret referrals from medical or allied health professionals

relevant legislation and organisational policies and procedures to maintain the safety of clients and the confidentiality of client information

causes and consequences of specific musculoskeletal considerations in the context of their effect on exercise capacity

principles of biomechanics to enable the application of appropriate exercise techniques for specific fitness activities

the role of physical activity in managing musculoskeletal conditions and enhancing health

use, care and maintenance of facility equipment to maintain safety of clients and other facility users.

The range statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Bold italicised wording, if used in the performance criteria, is detailed below. Essential operating conditions that may be present with training and assessment (depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts) may also be included.

Medical or allied health professional may include:

sports physician

sports doctor

general practitioner

physiotherapist

accredited exercise physiologist

occupational therapist

remedial massage therapist

chiropractor

osteopath

accredited practising dietician

psychologist

aboriginal health worker

diabetes educator.

Client may include:

aged

sedentary

overweight

presenting with additional medical or psychological conditions (including trauma)

athletes.

Relevant legislation may include:

Occupational Health and Safety

duty of care

privacy

codes of practice

fair trading.

Organisational policies and procedures may include:

Occupational Health and Safety

emergency procedures

risk management

use of client record systems

collection and use of client information

equipment use and maintenance

client supervision

incident reporting

client screening procedures

client referral procedures.

Risk factors may include:

family history

obesity

joint trauma and injury

menopause in females

repetitive occupational use

physical inactivity

eating disorders

low body weight and calcium intake

smoking.

Fitness assessment may include:

cardiovascular response to exercise

range of movement

strength

girth measurements.

posture.

Muscular conditioning may include:

muscular strength

muscular power

muscular endurance.

Instructional techniques may include:

establishing rapport

instructional position

demonstration and motivational strategies

positive feedback.

Exercise program may include:

exercise selection, sequence and variety

logical progression

warm-up and cool-down

stretching.

Exercise equipment may include:

cardiovascular equipment

resistance training machines:

hydraulic machines

aquatic equipment

resistance bands

free weights.

Monitor client responses may include:

rating of perceived exertion (RPE)

heart rate measures

'talk test'

possible fluctuations in blood glucose levels and dehydration.

Symptoms requiring interjection may include:

shortness of breath at rest or with mild exertion

dizziness or syncope

orthopnea or paroxysmal nocturnal dyspnea

palpitations or tachycardia

intermittent claudication

unusual fatigue or shortness of breath with usual activities

illness or sickness

lack of functional strength

neck soreness or strain

pain on movement of any body part.

Procedures to respond to symptoms requiring interjection include:

cessation and modification of activity

first aid

emergency medical assistance

referral.

Signs of unstable condition may include:

fatigue and weakness

cardiac pain

breathlessness

oedema

palpitations

claudication pain

dizziness.

Posture may include:

static

dynamic

standing

sitting

supine

specific observations of standing posture:

head and neck

thoracic spine

rib cage

shoulder position

scapula position

elbow position

lumbar spine

pelvis

abdominals

femur

knee

patella

foot position.

Postural variances may include:

structural

functional

kyphosis

rounded shoulders

winging of scapula

scoliosis

increased lordosis

decreased lordosis

excessive posterior pelvic tilt

excessive anterior pelvic tilt

genu varum

genu valgum

increased pronation of foot and or ankle complex

increased supination of foot and or ankle complex

hyperextension of knees

lateral tilt of pelvis

lateral tilt of head.

Functional anatomy of the joints may include:

glenohumeral

bones:

humerus

scapula

clavicle

ligaments:

corocohumeral

corococlavicular

glenohumeral

transverse humeral

related structures:

subscapular bursa

subacromial bursa

subdeltoid bursa

subcorocoid bursa

muscles acting on the joint

elbow

bones:

humerus

ulna

radius

ligaments:

ulnar collateral

radial collateral

related structures:

olecranon bursa

muscles acting on the joint

lumbo-sacral:

bones

5th lumbar vertebrae

1st vertebrae of sacrum

ligaments

muscles acting on the joint

intervertebral:

bones

vertebral bodies:

ligaments

muscles acting on the joint

hip (coxal)

bones:

femur

hip:

ligaments:

pubofemoral

iliofemoral

ischiofemoral

transverse ligament of acetabulum

ligament of head of femur

muscles acting on the joint

knee (tibiofemoral and or patellofemoral)

bones:

tibia

femur

patella

ligaments:

patella

oblique popliteal

arcuate popliteal

tibial collateral

fibular collateral

posterior cruciate

related structures:

tendons of the quadriceps femoris and facia latae

medial meniscus

lateral meniscus

prepatellar bursa

intrapatellar bursa

suprapatellar bursa

muscles acting on the joint

ankle (talocrucal):

bones:

talus

tibia

fibula

ligaments:

deltoid

anterior talofibial

posterior talofibial

calcaneofibular

related structures:

achilles tendon

muscles acting on the joint

Major joints may include:

intervertebral

glenohumeral

elbow

radiocarpal

sacroiliac

hip (coxal)

tibiofemoral

patello-femoral

ankle.

Joint movement may include:

flexion

extension

dorsiflexion

plantar flexion

horizontal flexion

horizontal extension

abduction

adduction

circumduction

rotation

supination

pronation

inversion

eversion

protraction

retraction

elevation

depression.

Muscles may include:

erector spinae

trapezius

rectus abdominis

internal obliques

external obliques

multifidus

quadratus lumborum

iliopsoas

latissimus dorsi

rhomboid major

rhomboid minor

pectoralis major

pectoralis minor

serratus anterior

levator scapulae

teres major

teres minor

subscapularis

supraspinatus

infraspinatus

gluteus maximus

gluteus medius

gluteus minimus

pelvic floor

iliotibial tract

tensor fascia latae

piriformis

rectus femoris

vastus lateralis

vastus medialis

vastus intermedius

sartorius

biceps femoris

semitendinosus

semimembranosus

gastrocnemius

soleus

tibialis anterior

adductor magnus

adductor longus

gracilis

sartorius.

Musculoskeletal conditions may include:

ostoepaenia

sub acute soft tissue injury and or sprain and or strain

osteoporosis

epicondylitis

tendonitis

osteoarthritis

repetitive strain injuries

Musculo-skeletal system may include:

functions

types of bones:

long

short

flat

irregular

growth and development of long bones

structure of long bones

classification of joints:

fibrous

cartilagenous

synovial structure of a synovial joint:

bones

articular or hyaline cartilage

joint capsule

joint cavity

ligaments

synovial membrane

synovial fluid

bursae

meniscus

connective tissue:

fascia

tendons

ligaments

muscular system

function of muscle tissue

properties of muscle tissue:

excitability

contractility

extensibility

elasticity

types of muscles:

smooth

cardiac

skeletal

structure of skeletal muscle tissue:

muscle belly

tendon

fascicle

muscle fibre

myofibril

microscopic anatomy:

sarcomere

filaments

actin

myosin

tropomyosin

troponin

sarcolemma

sarcoplasm

sarcoplasmic reticulum

T-tubules

Z lines

A band

I band

muscle contraction:

sliding filament theory

length-tension relationship

attachments:

origin

insertion

role of muscle contraction:

agonist

antagonist

fixator

synergist

skeletal muscle fibre types:

slow twitch oxidative

fast twitch oxidative-glycolytic

fast twitch glycolytic

distribution and recruitment of different fibre types

physiological adaptations due to training:

hypertrophy

increased strength

increased extensibility

muscle actions of major muscles.

Moderate risk client may include:

chronic disease state

medical condition or injury

under prescribed medication

symptoms of cardiorespiratory disease

moderate or high risk as identified by medical or allied health professional

aged and sedentary

musculoskeletal moderate risk includes:

history of injury to back or neck or joints or muscles of arms and legs requiring assessment and or treatment by a medical or allied health professional but is now fully resolved

previous surgery to back or neck or joints or muscles of arms and legs

recurrent injury

injury to musculoskeletal system in the past 8 weeks even if it has resolved

recent low level of physical activity

hyper mobile

Copy and paste from the following performance criteria to create an observation checklist for each task. When you have finished writing your assessment tool every one of these must have been addressed, preferably several times in a variety of contexts. To ensure this occurs download the assessment matrix for the unit; enter each assessment task as a column header and place check marks against each performance criteria that task addresses.

Observation Checklist

Tasks to be observed according to workplace/college/TAFE policy and procedures, relevant legislation and Codes of Practice Yes No Comments/feedback
Receive exercise referral from an accredited exercise physiologist or relevant medical or allied health professional. 
Confirm exercise referral has sufficient detail to allow flexibility for modifications to accommodate progression of the client. 
Become familiar with typical adverse signs and symptoms that may arise during exercise for this pathology. 
Discuss with the client their complete exercise history and their musculoskeletal condition and record relevant information according to relevant legislation and organisational policies and procedures. 
Explain the physiology of musculoskeletal considerations and associated risk factors to the client in simple terms and confirm client understanding. 
Explain to the client the causes and consequences of specific musculoskeletal conditions in the context of their effect on exercise capacity and conditions. 
Explain to the client the role of physical activity in managing musculoskeletal conditions and enhancing health. 
Undertake appropriate fitness assessments as required. 
Work with medical or allied health professional to deliver an exercise plan in accordance with recognised exercise recommendations, fitness test results, client limitations, and potential interactions of medications. 
Explain to the client the role of muscular conditioning, and the reasons for their inclusion as part of the client's exercise prescription. 
Explain to the client the exercise variables to be delivered in the context of managing their specific musculoskeletal conditions. 
Apply instructional techniques to ensure safe and appropriate application of the exercise program by the client. 
Demonstrate the safe and appropriate use of selected exercise equipment and report or address any unsafe equipment according to organisational policies and procedures. 
Monitor perceived exercise intensity and make adjustment as required. 
Assess the client's performance and explain and correct any unsafe exercise procedures. 
Monitor client responses for any typical signs and symptoms requiring intervention that may occur during exercise. 
Recognise signs of an unstable condition and refer the client back to an appropriate medical or allied health professional. 
Report outcomes to referral source as well as client. 
Discuss the information obtained through observation of the client's static and dynamic posture with the referring accredited exercise physiologist, or relevant medical or allied health professional to deliver an exercise program to reduce the progression of postural variances and to minimise the risk of injury during fitness activities. 
Identify major bones, joints and their related connective tissue structures, and the major muscles acting on these joints when delivering exercise programs for clients. 
Identify and describe to clients the functional anatomy of the major joints when delivering rehabilitation exercise programs for clients with musculoskeletal conditions. 
Apply knowledge of the structure and function of the musculoskeletal system and basic biomechanics to posture, functional stability and locomotion when delivering exercise programs for moderate risk clients. 
Apply an understanding of the fundamental structural and functional differences affecting the mobility and stability of the pectoral girdle, pelvic girdle and vertebral column when undertaking screening and programming for clients with postural concerns. 
Apply the structural adaptations of musculoskeletal tissue in response to exercise, mechanical stress and disease to exercise programming for moderate risk clients. 
Explain to clients the process of bone remodelling and muscle tissue repair in response to injury when dealing with musculoskeletal conditions. 
Describe the effects of ageing and inactivity on musculoskeletal tissue and apply to exercise delivery to clients. 
Apply the effect of individual structural differences on exercise performance to the delivery of exercise programs for moderate risk clients. 

Forms

Assessment Cover Sheet

SISFFIT526A - Deliver prescribed exercise to clients with musculoskeletal conditions
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