SISFFIT524A
Deliver prescribed exercise to clients with metabolic conditions

This unit describes the performance outcomes, skills and knowledge required to deliver prescribed exercise programs to stable clients with metabolic conditions in collaboration with medical or allied health professionals.No licensing, legislative, regulatory or certification requirements apply to this unit at the time of endorsement.

Application

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 metabolic 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.


Prerequisites

Nil


Elements and Performance Criteria

ELEMENT

PERFORMANCE CRITERIA

1. Consult with referred clients presenting with stable metabolic conditions.

1.1. Receive exercise referral from an accredited exercise physiologist or relevant medical or allied health professional.

1.2. Confirm exercise referral has sufficient detail to allow flexibility for modifications to accommodate progression of the client.

1.3. Become familiar with typical adverse signs and symptoms that may arise during exercise for this pathology.

1.4. Consult with a relevant medial or allied health professional as necessary.

1.5. Discuss with the client their complete exercise history and their metabolic condition and co-morbidities and record information according to relevant legislation and organisational policies and procedures.

1.6. Explain the physiology of the metabolic condition and associated risk factors to the client in simple terms and confirm client understanding.

1.7. Explain to the client the causes and consequences of the different components of the metabolic condition in the context of their effect on exercise capacity and condition.

1.8. Explain to the client the role of physical activity in managing metabolic conditions and enhancing health.

1.9. Confirm the outcomes of goals and needs analysis in collaboration with the client and the medical or allied health professionals if appropriate.

1.10. Explain to the client their need to be referred back to a medical or allied health professional if their condition becomes unstable.

1.11. Identify any potential barriers to exercise and discuss methods to enhance exercise adherence with the client.

1.12. Clarify any areas of concern with the referring accredited exercise physiologist, or relevant medical or allied health professional in conjunction with the client.

1.13. Obtain the informed consent of the client and maintain the client's records according to relevant legislation and organisational policies and procedures.

2. Deliver prescribed exercise programs.

2.1. Undertake appropriate fitness assessments as required.

2.2. Work with medical or allied health professionals to deliver an exercise plan in accordance with recognised exercise recommendations, fitness test results, client limitations, and potential interactions of medications.

2.3. Explain to the client the role of muscular conditioning, and the reasons for their inclusion as part of the client's exercise prescription.

2.4. Apply instructional techniques to ensure safe and appropriate application of the exercise program by the client.

2.5. Explain to the client the exercise variables to be delivered in the context of managing their specific metabolic conditions.

2.6. Demonstrate the safe and appropriate use of selected exercise equipment and report or address any unsafe equipment according to organisational policies and procedures.

3. Monitor and review clients responses to the prescribed exercise program

3.1. Monitor perceived exercise intensity and make adjustment as required.

3.2. Assess the client's performance and explain and correct any unsafe exercise procedures.

3.3. Monitor client responses for any typical signs and symptoms requiring intervention that may occur during exercise.

3.4. Apply procedures to respond to signs and symptoms requiring intervention as required according to relevant legislation and organisational policies and procedures.

3.5. Recognise signs of an unstable condition and refer the client back to a relevant medical or allied health professional.

3.6. Report outcomes to the referred source as well as the client.

3.7. Revise the client's record and advise the referral source of suggested changes to the exercise program if required.

4. Provide advice regarding additional lifestyle modifications to enhance the management of the condition.

4.1. Obtain information about the client's current lifestyle.

4.2. Identify to client appropriate and non-appropriate methods of managing body composition.

4.3. Explain to the client the negative health effects of poor management of body composition.

4.4. Provide information in accordance with healthy eating guidelines to improve general health and enhance the management of the metabolic condition.

4.5. Discuss the physiological mechanisms of decreasing adipose tissue in a method that is understandable to the client.

4.6. Explain the importance of healthy eating for body composition management to the client.

4.7. Explain the effect of exercise on management of body composition.

4.8. Recommend other lifestyles changes to improve current disease status.

4.9. Discuss possible barriers to behaviour change and implementation of healthy eating practices.

5. Apply extensive knowledge of the anatomy and physiology of the endocrine system to the delivery of exercise programs for moderate risk clients

5.1. Apply knowledge of the structure and function of the endocrine system to the delivery of exercise for relevant medical conditions or injuries.

5.2. Apply knowledge of the effects ofhormoneson metabolism and energy production when providing information to clients regarding exercise, healthy eating and body composition management.

5.3. Explain the interrelationship between the nervous system and the endocrine system to control body systems to moderate risk clients.

5.4. Explain the effects of some of the medical conditions and disorders on homeostasis of the endocrine system.

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

6.1. Explain clearly the structure and function of the digestive system when providing advice relating to healthy eating, metabolism and body composition management to clients.

6.2. Use an understanding of the process of digestion and absorption of food in relation to energy production when providing information to 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.

problem-solving 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, lipid-lowering agents and their effects on the condition

effect of metabolic conditions on the acute response to exercise to enable assessment of the individual's 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 client's 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

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

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


Sectors

Unit sector

Fitness


Employability Skills

This unit contains employability skills.


Licensing Information

Refer to Unit Descriptor