Certificate in Personal Training Case-Study Marking Checklist Unit Number: 500/8259/0of 2

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1 Candidate Name: Assessor Name: IV Name: Certificate in Personal Training Case-Study Marking Checklist Unit Number: 500/8259/0of 2 Date: Date: NB: Candidates must achieve enough passes to show competency across all sections. Candidates are allowed no more than 1 R in any section. An R in a shaded box is an automatic refer. P Pass Q Question * Pass with comment R Refer R Referral overall N/A Date (1) Client Profile & Physical Activity Record The candidate produced a programme that: 1. Gathered information to create an appropriate client profile (to include PAR-Q) 2. Described client s lifestyle 3. Described client s past and present activity levels (FITT) 4. Described client s attitudes to physical activity 5. Identified stage of readiness to change 6. Identified client s activity likes and dislikes 7. Demonstrated understanding of this section within the viva P (2) Goal Setting The candidate set short-term and long-term goals that are: 8. Specific 9. Measurable 10. Achievable/Agreed 11. Realistic 12. Time framed 13. Identified any barriers to achieving goals 14. Proposed strategies for overcoming any barriers identified 15. Demonstrated understanding of this section within the viva (3) Programming The candidate set short-term and long-term goals that are: 16. Included an appropriate number of sessions to the client s goals and wants 17. Clearly related to the client s long-term goals 18. Clearly related to client s short-term goals 19. Specified CV exercises in terms of FITT appropriate to client 20. Specified RT exercises in terms of FITT appropriate to client 21. Included a minimum of 2 different CV training systems 22. Included a minimum of 4 different RT training systems 23. Progressed appropriately to the client s wants, likes and barriers (physically and/or psychologically) 24. Included environments not specifically designed for exercise 25. Listed appropriate warm-up and cool-down activities 26. Included a minimum of 1 core stability exercise 27. Included a minimum of 1 PNF stretch 28. The learner produced a 12-week overview that showed projected, logical progression of the 4-week plan. 29. Demonstrated understanding of this section within the viva (4) Evaluating The candidate set short-term and long-term goals that are: 30. Recorded any adjustments made 31. Evaluated the effectiveness of the session 32. Evaluated feedback gained from the client

2 Client Name: Address: Post code: Gender: Innervate Training: CYQ Level 3 Certificate in Personal Training Case-Study SECTION 1: CLIENT PROFILE Age: Height: MEDICAL HISTORY YES NO 1. Has your doctor ever said that you have a heart condition and that you should only do physical activity unless recommended by a doctor? 2. Do you feel pain in your chest when you do physical activity? 3. In the past month, have you had a chest pain when you were not doing physical activity? 4. Do you lose balance because of dizziness or do you ever lose consciousness? 5. Do you have a bone or joint problem that could be made worse by a change in your physical activity? 6. Is your doctor currently prescribing you drugs (for example water pills) for your blood pressure or heart? 7. Do you know any other reason why you should not do physical activity? If your client has answered yes to any of the pre-exercise questions, please provide details below including how this may affect their participation during the programme. INFORMED CONSENT I fully understand that my participation in this programme is completely voluntary and I may withdraw from the prescribed exercises at any time. I also confirm that I understand that exercise involves inherent but unlikely risk of injury and in extreme circumstances the possibility of death. By signing below I confirm that I have answered honestly all of the pre-exercise medical questions and release: (instructor) from any liability with respect to any damage or injury which I may suffer whilst exercising. Client Name: Instructor Name:

3 CHD RISK ASSESSMENT INSTRUCTIONS Please read carefully and answer honestly the following questions regarding ones risk of Coronary Heart Disease (CHD) and Coronary Artery Disease (CAD). If you are unsure about a particular question you should seek clarification from your instructor or G.P. PRIMARY RISK QUESTIONS 1. Are you a current cigarette smoker or one who has quit within the last 6 months? 2. Do you have a history of heart disease within your family? or Has a male first degree relative under 55 or a female first degree relative under 65 suffered from a heart attack, stroke or sudden death? 3. Do you suffer from high blood pressure (140 / 90 mm Hg) and has this been confirmed with measurements on 2 separate readings? 4. Are you classified as obese? If so please also indicate the method used to assess your obesity (BMI, % BF, hips-waist etc). SECONDARY RISK QUESTIONS 5. Do you suffer from diabetes? If so please indicate the type & whether you are insulin / glucagon dependant. 6. Are you sedentary? This simply means so you meet the NICE / HEA guidelines for physical activity or ACSM minimum guidelines for structured exercise? 7. Do you suffer from high cholesterol (hypercholesterolemia)? 8. Are you a male over the age of 45 or a female over the age of 55 who has previously been sedentary? RISK STRATIFICATION MORE THAN 1 PRIMARY RISK FACTOR Individuals with more than 1primary risk factor should delay becoming more active until they have sought medical clearance from a G.P. MORE THAN 2 SECONDARY RISK FACTORS Those with more than 2 secondary risk factors should also delay becoming more physically active until they have sought medical clearance from a G.P.

4 MEDICAL CLEARANCE FORM Dear Doctor: Your patient wishes to take part in an exercise program and / or fitness assessment. The exercise program may include progressive resistance training, flexibility exercises, and a cardiovascular program; increasing in duration and intensity over time. The fitness assessment may include a sub-maximal cardiovascular fitness test and measurements of body composition, flexibility, and muscular strength and endurance. After completing a readiness questionnaire and discussing their medical condition(s) we agreed to seek your advise in setting limitations to their program. By completing this form, you are not assuming any responsibility for our exercise and assessment program. Please identify any recommendations or restrictions for your patient's fitness program below (G.P s Recommendations). PATIENTS CONSENT / AUTHORISATION I consent to and authorize to release to, health information concerning my ability to participate in an exercise program and/or fitness assessment. I understand this consent is revocable except to the extent action has already been taken. Authorization is not valid beyond one year from date of signature. Further disclosure or release of my health information is prohibited without specific written consent of person to whom it pertains. Client Signature: Instructor Signature: Date: Date: G.P RECOMMENDATIONS I am not aware of any contraindications toward participation in a fitness program. I believe the applicant can participate, but urge caution because: The applicant should not engage in the following activities: I recommend the applicant not participate in the above fitness program. Doctors Signature: Date: Print name: Phone no: N.B. If medical approval is required, this document should be printed and signed by hand by the appropriate medical practitioner.

5 Client Exercise Profile Using the FITT principle, describe your clients current exercise level. Frequency: Intensity: Type Time: Client Physical Activity Profile Using the FITT principle, describe your client s current physical activity level. Frequency: Intensity: Type Time: Exercise Comparison Using the FITT principle, compare your client s previous exercise history with their current exercise levels. Activity Comparison Using the FITT principle, compare your client s previous physical activity history with their current level of physical activity. If there are any differences between your client s current & previous level of physical activity / exercise, explain the reasons for these differences. Describe your client s current attitude, motivation & outlook towards exercise.

6 EXERCISE PREFERENCES In the space below, identify the types of exercise your clients like to regularly perform (if any). PHYSICAL ACTIVITY PREFERENCES Identify the physical activities you client enjoys performing on a regular basis; this should not include information about exercise or sports performance. LIFESTYLE PROFILE Using the bullets below, provide a brief profile of your clients current lifestyle activities including any recommendations you have made to you client. You may tie these recommendations into your client s goal setting contract. Cigarette use: How many do they smoke, how long have they smoked and what are your recommendations? Alcohol consumption: How many units per day / week, how do they consume these units (binge / evenly) and what do they drink? Nutritional summary: Provide examples of your client s nutritional strengths and weakness.

7 SECTION 2: EXERCISE GOAL SETTING S Long-term Goals M A R T Short-term Goals S S S M M M A A A R R R T T T Comments:

8 BARRIERS TO PARTICIPATION Under the following headings; identify any current or potential barriers that may influence your client s adherence to the planned programme of exercise. Extrinsic Barriers (injury, lack of facilities / resources, family commitments etc): Intrinsic Barriers (low motivation, self esteem, confidence & efficacy etc): OVERCOMING BARRIERS TO PARTICIPATION Using the barriers identified above, identify how you plan to assist your client overcome these barriers and maximise their adherence to the planned programme of exercise. Strategies for overcoming extrinsic barriers: Strategies for overcoming intrinsic barriers:

9 STAGE OF READINESS TO CHANGE Using the boxes below, identify which stage of the change process your client is at. Pre-contemplation Termination Contemplation Relapse Maintainance Preparation Action State why you believe your client is at the above stage and explain what your are going to do to help them move through the change to make their exercise behaviour(s) become more permanent.

10 Venue: Treadmill Upright cycle R-cycle Stepper Rower Cross trainer Resistance machines Cable machines Bars / collars Dumbbells Benches Mats Open space DESCRIBE THE LOCATION OF: EMERGENCY EXITS Innervate Training: CYQ Level 3 Certificate in Personal Training Case-Study PLANNING ASSESSMENT FORM Equipment Number N/A NEAREST TELEPHONE FIRST AID EQUIPMENT (Including the location of any qualified personnel). DISCUSS THE PROCEDURES FOR: PARTICIPANT SCREENING PARTICIPANT REFERRAL PARTICIPANT & INSTRUCTOR CLOTHING VENTILATION & TEMPERATURE

11 DESCRIBE THE VENUES CONTROL OF: LIGHTING (is this sufficient in all areas?) WATER AVAILABILITY? (Where & how provided?) FLOORING (Type of flooring, available space, is it level etc?) EQUIPMENT: WHAT EQUIPMENT CHECKS WILL BE COMPLETED PRIOR TO THE SESSION? (including electrical equipment) WHO WILL YOU REPORT FAULTY EQUIPMENT OR OTHER HEALTH & SAFETY BREACHES TO? DESCRIBE THE EMERGENCY PROCEDURES FOR: MEDICAL EMERGENCY (Heart attack, stroke etc). NON-MEDICAL EMERGENCY (Fire or suspected bomb). WHAT ACTION WILL YOU TAKE THROUGHOUT THE SESSION TO ENSURE YOUR CLIENT REMAINS SAFE? N.B. Duplicate this document if more than 1 environment is used for teaching this programme.

12 PROGRAMME OVERVIEW RESISTANCE Week 1-4 Week 5-8 Week 9-12 Week Frequency Sets Reps Intensity Rest %1RM Time Type CARDIO Week 1-4 Week 5-8 Week 9-12 Week Frequency Intensity (%HRR & RPE) Time Type N.B. The above programme must demonstrate the principles of periodisation (reduced volume, increased intensity and increased specificity).

13 WARM UP OVERVIEW Week 1-4 Week 5-8 Week 9-12 Week MOBILITY & PULSE-RAISER Exercise: Exercise: Exercise: Exercise: Intensity: Intensity: Intensity: Intensity: Duration: Duration: Duration: Duration: PRE-STRETCH Muscles: Muscles: Muscles: Muscles: Type: Type: Type: Type: Duration: Duration: Duration: Duration:

14 COOL-DOWN OVERVIEW Week 1-4 Week 5-8 Week 9-12 Week POST WORKOUT STRETCH Muscles: Muscles: Muscles: Muscles: Type: Type: Type: Type: Duration: Duration: Duration: Duration: REVITALISER / REJUVINATOR Activity: Activity: Activity: Activity: Duration: Duration: Duration: Duration: Intensity: Intensity: Intensity: Intensity:

15 RESISTANCE PROGRAMME CARD 1 TRAINING DAYS: AIM: WEEK: 1 TRAINING METHOD: DAY EXERCISE SETS REPS REST % 1RM COACHING POINTS ALT, ADAPT, PROG

16 RESISTANCE PROMGRAMME CARD 1 CONT.. DAY EXERCISE SETS REPS REST % 1RM COACHING POINTS ALT, ADAPT, PROG

17 RESISTANCE PROGRAMME CARD 2 TRAINING DAYS: Innervate Training: CYQ Level 3 Certificate in Personal Training Case-Study AIM: WEEK: 2 TRAINING METHOD: DAY EXERCISE SETS REPS REST % 1RM COACHING POINTS ALT, ADAPT, PROG

18 RESISTANCE PROGRAMME CARD 2 CONT DAY EXERCISE SETS REPS REST % 1RM COACHING POINTS ALT, ADAPT, PROG

19 RESISTANCE PROGRAMME CARD 3 TRAINING DAYS: AIM: WEEK: 3 TRAINING METHOD: DAY EXERCISE SETS REPS REST % 1RM COACHING POINTS ALT, ADAPT, PROG

20 RESISTANCE PROGRAMME CARD 3 CONT. DAY EXERCISE SETS REPS REST % 1RM COACHING POINTS ALT, ADAPT, PROG

21 RESISTANCE PROGRAMME CARD 4 TRAINING DAYS: Innervate Training: CYQ Level 3 Certificate in Personal Training Case-Study AIM: WEEK: 4 TRAINING METHOD: DAY EXERCISE SETS REPS REST % 1RM COACHING POINTS ALT, ADAPT, PROG

22 RESISTANCE PROGRAMME CARD 4 DAY EXERCISE SETS REPS REST % 1RM COACHING POINTS ALT, ADAPT, PROG

23 TRAINING DAYS: MAX HEART RATE: TRAINING ZONE: Innervate Training: CYQ Level 3 Certificate in Personal Training Case-Study CV TRAINING PROGRAMME CARD 1 TRAINING METHOD: HRR: EXERCISE MODE (S): DURATION: BUILD UP TARGET ZONE COOL-DOWN ALTERNATIVE EXERCISE: ALTERNATIVE ACTIVITY: (Refer to criteria 24 in the marking checklist)

24 TRAINING DAYS: MAX HEART RATE: TRAINING ZONE: Innervate Training: CYQ Level 3 Certificate in Personal Training Case-Study CV TRAINING PROGRAMME CARD 2 TRAINING METHOD: HRR: EXERCISE MODE (S): DURATION: BUILD UP TARGET ZONE COOL-DOWN ALTERNATIVE EXERCISE: ALTERNATIVE ACTIVITY: (Refer to criteria 24 in the marking checklist)

25 TRAINING DAYS: MAX HEART RATE: TRAINING ZONE: Innervate Training: CYQ Level 3 Certificate in Personal Training Case-Study CV TRAINING PROGRAMME CARD 3 TRAINING METHOD: HRR: EXERCISE MODE (S): DURATION: BUILD UP TARGET ZONE COOL-DOWN ALTERNATIVE EXERCISE: ALTERNATIVE ACTIVITY: (Refer to criteria 24 in the marking checklist)

26 TRAINING DAYS: MAX HEART RATE: TRAINING ZONE: Innervate Training: CYQ Level 3 Certificate in Personal Training Case-Study CV TRAINING PROGRAMME CARD 4 TRAINING METHOD: HRR: EXERCISE MODE (S): DURATION: BUILD UP TARGET ZONE COOL-DOWN ALTERNATIVE EXERCISE: ALTERNATIVE ACTIVITY: (Refer to criteria 24 in the marking checklist)

27 Date: Innervate Training: CYQ Level 3 Certificate in Personal Training Case-Study CERTIFICATE IN PERSONAL TRAINING PROGRAMME EVALUATION- WEEK 1 CRITERIA MY COMMENTS CRITERIA MY COMMENTS How well do you feel your sessions achieved their planned aims and objectives? (specified in your lesson plan) What progress has your client made during the last week? How effective was the information you delivered to your client (demonstrations and explanations). How accurate was the information you delivered? (Muscles used, exercise benefits etc). How effective was your use of specific coaching points? Was the intensity of all the exercises used, appropriate to the component and clients fitness level? Was the intensity of all the exercises used, appropriate to the component and clients fitness level? Summarise the changes made to the programme during the programming period: How well did you explain the specific benefits and purpose of the advanced training method? How well do you feel you instilled confidence, efficacy and motivation in your client to promote adherence? Client Feedback

28 Date: Innervate Training: CYQ Level 3 Certificate in Personal Training Case-Study CERTIFICATE IN PERSONAL TRAINING PROGRAMME EVALUATION- WEEK 2 CRITERIA MY COMMENTS CRITERIA MY COMMENTS How well do you feel your sessions achieved their planned aims and objectives? (specified in your lesson plan) What progress has your client made during the last week? How effective was the information you delivered to your client (demonstrations and explanations). How accurate was the information you delivered? (Muscles used, exercise benefits etc). How effective was your use of specific coaching points? Was the intensity of all the exercises used, appropriate to the component and clients fitness level? Was the intensity of all the exercises used, appropriate to the component and clients fitness level? Summarise the changes made to the programme during the programming period: How well did you explain the specific benefits and purpose of the advanced training method? How well do you feel you instilled confidence, efficacy and motivation in your client to promote adherence? Client Feedback

29 Date: Innervate Training: CYQ Level 3 Certificate in Personal Training Case-Study CERTIFICATE IN PERSONAL TRAINING PROGRAMME EVALUATION- WEEK 3 CRITERIA MY COMMENTS CRITERIA MY COMMENTS How well do you feel your sessions achieved their planned aims and objectives? (specified in your lesson plan) What progress has your client made during the last week? How effective was the information you delivered to your client (demonstrations and explanations). How accurate was the information you delivered? (Muscles used, exercise benefits etc). How effective was your use of specific coaching points? Was the intensity of all the exercises used, appropriate to the component and clients fitness level? Was the intensity of all the exercises used, appropriate to the component and clients fitness level? Summarise the changes made to the programme during the programming period: How well did you explain the specific benefits and purpose of the advanced training method? How well do you feel you instilled confidence, efficacy and motivation in your client to promote adherence? Client Feedback

30 Date: Innervate Training: CYQ Level 3 Certificate in Personal Training Case-Study CERTIFICATE IN PERSONAL TRAINING PROGRAMME EVALUATION- WEEK 4 CRITERIA MY COMMENTS CRITERIA MY COMMENTS How well do you feel your sessions achieved their planned aims and objectives? (specified in your lesson plan) What progress has your client made during the last week? How effective was the information you delivered to your client (demonstrations and explanations). How accurate was the information you delivered? (Muscles used, exercise benefits etc). How effective was your use of specific coaching points? Was the intensity of all the exercises used, appropriate to the component and clients fitness level? Was the intensity of all the exercises used, appropriate to the component and clients fitness level? Summarise the changes made to the programme during the programming period: How well did you explain the specific benefits and purpose of the advanced training method? How well do you feel you instilled confidence, efficacy and motivation in your client to promote adherence? Client Feedback I would make the following changes to my future sessions:

31 AUTHENTICITY STATEMENT: I the undersigned do hereby acknowledge that by placing a check in the box below I am confirming that the contents of this document is entirely my own work and has not been plagiarised or copied from another source. I also confirm that the content of this document is true and accurate to the best of my knowledge. Print: Date: Check the box to confirm authenticity:

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