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Elements and Performance Criteria

  1. Consult with referred clients presenting with stable metabolic conditions.
  2. Deliver prescribed exercise programs.
  3. Monitor and review clients responses to the prescribed exercise program
  4. Provide advice regarding additional lifestyle modifications to enhance the management of the condition.
  5. Apply extensive knowledge of the anatomy and physiology of the endocrine system to the delivery of exercise programs for moderate risk clients
  6. Apply knowledge of the structure and function of the digestive system when providing advice about healthy eating and body composition to moderate risk clients

Required Skills

Required skills

communication skills appropriate to the age and values of referred clients with metabolic conditions

skills to identify adverse signs and symptoms requiring intervention and unsafe exercise performance and to recommend appropriate changes in consultation with an appropriate medical or allied health professional

problemsolving skills to identify symptoms requiring interjection and unsafe exercise performance and to recommend appropriate changes

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

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

decision making skills to determine appropriate instructional techniques

literacy and numeracy skills to enable the accurate interpretation of referrals and to record client exercise programs and calculate and adjust exercise duration and frequency

Required knowledge

components of metabolic conditions and the associated risk factors

the pathology of metabolic conditions and considerations in relation to the needs of the client

structure and function of the endocrine system to enable understanding of physiological responses to exercise and their relationship to the condition and needs of clients

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

effects of hormones on metabolism and energy production and the regulation of basic physiological responses to exercise to enable the provision of accurate information to clients regarding exercise

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

relationship between metabolic conditions and other conditions such as cardiovascular disease

recognised recommendations for exercise testing and prescription for metabolic conditions

categories of medications used to manage metabolic conditions such as oral hypoglycaemic agents including insulin antihypertensives lipidlowering agents and their effects on the condition

effect of metabolic conditions on the acute response to exercise to enable assessment of the individuals functional capacity when developing exercises

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

motivational psychology to enable identification and mitigation of barriers to exercise adherence

industry recognised guidelines associated with exercise prescription and delivery

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

Evidence Required

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 professionals regarding relevant health and functional status of the referred clients and discusses aspects of exercise prescription with clients

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

correctly interprets the exercise prescription and make modifications consistent with prescribed parameters and scope of practice

safely and effectively delivers exercise for referred clients with cardiorespiratory conditions and recommends appropriate alterations according to clients physical and motivational response

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 exercise for clients with metabolic conditions

Assessment must also ensure access to

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

a range of real or simulated medical or allied health professionals referrals for a range of referred clients with metabolic 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 metabolic 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 needs 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 or written questioning to assess knowledge of the physiology of metabolic conditions and associated risk factors and the use and effect of medications

thirdparty 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

SISFFITA Deliver prescribed exercise to clients with cardiorespiratory conditions

SISFFIT523A Deliver prescribed exercise to clients with cardiorespiratory conditions

SISFFITA Deliver prescribed exercise to children and young adolescents with specific chronic conditions

SISFFIT530A Deliver prescribed exercise to children and young adolescents with specific chronic conditions

Guidance information for assessment


Range Statement

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.

Client may include:

older

sedentary

overweight and obese

presenting with additional medical or psychological conditions.

Metabolic condition must include:

dyslipidaemias

obesity

hyperglycaemia

hyperinsulinaemia

pre-diabetes

hyperparathyroidism

diabetes Type I or Type II: controlled

polycystic ovary

Hyperthyroidism and or Graves Disease

Hypothyroidism

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 such as diabetes

smoking

hypertension; systolic blood pressure of =140 mm hg or diastolic =90 mm hg confirmed by measurement on at least two separate occasions, or taking any antihypertensive medication

hypercholesterolaemia; total serum cholesterol of >200 mg/dl [5.2 mmol/l] or high density lipoprotein cholesterol of <35 mg/dl [0.9 mmol/l], or on lipid-lowering medication

impaired fasting glucose; fasting blood glucose of =110mg/dl confirmed by measurements on at least 2 separate occasions

obesity; body mass index of =30kg/m2 or waist girth of > 100cm for males, = 88cm for women or waist/height ration of = 0.5 cm

sedentary lifestyle; persons not participating in a regular exercise program or accumulating 30 minutes or more of moderate physical activity most days of the week

heart conditions.

Goals and needs analysis may include:

timeframes

appropriate exercise program adjustments

barriers

motivation.

Methods to enhance exercise adherence may include:

rewards for attendance and participation

statement of intent

perceived choice

goal setting.

Potential barriers may include:

perceived versus actual barriers

initial low fitness level and probable overweight or obesity

time and access to facilities

self-consciousness in client

concerns for health.

Fitness assessment may include:

range of movement

strength

girth measurements

body mass.

waist to height ratio.

Muscular conditioning may include:

muscular strength

muscular power

muscular endurance.

Records may include:

electronic

hand written.

Exercise program may include:

exercise selection

exercise sequence

exercise variety

logical progression.

Exercise equipment may include:

cardiovascular equipment:

stepper

rowing machine

stationary bicycle

treadmill

free weight equipment

resistance training machines

hydraulic machines

aquatic equipment

resistance bands.

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 intervention may include:

shortness of breath at rest or with mild exertion

dizziness or syncope

orthopnea or paroxysmal nocturnal dyspnea

palpitations or tachycardia

symptoms of hypoglycaemia and hyperglycaemia

intermittent claudication

unusual fatigue or shortness of breath with usual activities

illness or sickness

unaccustomed lack of functional strength

soreness or strain

pain on movement of any body part.

Procedures to respond to symptoms requiring intervention must include:

cessation 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.

Negative health effects may include:

eating disorders:

bulimia

anorexia

obesity

diabetes

hypertension

cardiovascular disease

cancer

joint degeneration.

Lifestyle modifications may include:

moderation of alcohol consumption

cessation of smoking

increased incidental activity

stress reduction

provision of health eating guidelines

provision of healthier choices.

Endocrine system may include:

role and function of the endocrine system

endocrine glands

pituitary

adrenal

parathyroid

pancreas

gonads

thymus

hormones

types

hormone transport in the blood

hormone action

control of hormone action

control of hormone secretion

abnormal secretion

role of endocrine system in stress and disease

effects of ageing on the endocrine system

disorders or homeostatic imbalances

diabetes.

Hormones may include:

human growth hormone

anti-diuretic hormone (vasopressin)

calcitonin

aldosterone

insulin.

Nervous system may include:

divisions:

central nervous system

peripheral nervous system:

somatic nervous system

autonomic nervous system

central nervous system:

brain

spinal cord

peripheral nervous system:

cranial nerves

spinal nerves

peripheral nerves

plexus

neurons:

afferent

efferent

motor

sensory

histology of nerve tissue:

neuron:

axon

dendrites

nucleus

cell body

node of ranvier

neurilemma

myelin sheath

scwann cell

neuroglia

brain:

structure

brain stem

cerebral hemispheres

ventricles

cranial nerves

meninges

cerebrospinal fluid

blood supply:

sensory areas and pathways

motor areas and pathways

nerve impulses:

resting membrane potentials

graded potentials

action potentials

refractory period

subthreshold stimulation

all or none law

summation:

spatial

temporal

neuromuscular transmission:

neuromuscular junction

transmission

synaptic transmission:

synapse

excitation at synapse

inhibition at synapse

spinal reflexes:

reflex arc

receptors

reflex action

types of reflexes

spinal cord:

structure

spinal nerves

peripheral nerves:

cervical plexus

brachial plexus

lumbosacral plexus

regeneration and repair of nervous tissue

effects of ageing on the nervous system

disorders of the nervous system:

multiple sclerosis

epilepsy

nerve injuries

cerebrovascular accident

sensory receptors:

interoreceptors

exteroreceptors

sensory organs:

eye:

structure

accessory organs

vision:

formation of image

proprioreceptors:

visual acuity

visual fields

visual pathways

visual defects

ear:

structure

hearing

conduction of sound

auditory pathway

hearing defects

equilibrium

Moderate risk clients may include:

chronic disease state

medical condition or injury

under prescribed medication

symptoms of cardiorespiratory disease

those identified by medical or allied health professionals

older and sedentary.

Digestive system may include:

structure:

mouth

oesophagus

stomach

small intestine

large intestine

rectum

anus

sphincters

glands:

salivary glands

pancreas

liver

gall bladder

blood supply

innervation

role in energy production

digestion:

breakdown

motor functions:

mastication

peristalsis

segmentation

deglutition

gastric motility

intestinal motility

secretion of enzymes

secretion of juices

enzymes:

secretion

function

absorption:

carbohydrate

lipids

protein

water and electrolytes

vitamins

chemical composition of foods

metabolism of foodstuffs:

oxidation of food

by-products

storage

regulation of metabolism:

choice of metabolic pathway

carbohydrate metabolism

fat metabolism

protein metabolism

Medical conditions and disorders may include:

conditions affecting the endocrine system:

diabetes

conditions affecting the nervous system:

retinopathy

peripheral neuropathy

quadriplegia

paraplegia

cerebral palsy

muscular dystrophy

Parkinson's disease