Following the study of this article, the reader should be able to:
- Define the purpose of an Integrated Fitness Profile.
- Describe the components of an Integrated Fitness Profile.
- Provide general and medical questions to gather subjective information.
- Describe the importance of posture and the postural distortions that exist.
- Perform a series of comprehensive movement observations to obtain objective information.
Designing an individualized, systematic, integrated fitness program can only be properly accomplished by having an understanding of a client’s goals, needs and abilities. This entails knowing what a client wants to gain from a training program, what a client needs from their program to successfully accomplish their goal(s) and how capable they are structurally and functionally of performing the required tasks within an integrated program. The information necessary to create the right program for a specific individual or groups of individuals comes through proper integrated fitness profile. The remainder of this article will focus on an integrated fitness profile for the fitness professional. It will specifically illuminate what a fitness profiles are, their importance, which observations can be used and most importantly, what they tell the fitness professional and how to make proper use of the information.
Integrated Fitness Profile
An Integrated Fitness Profile is a systematic problem-solving method that provides the fitness professional with a basis for making educated decisions about exercise and acute variable selection. They provide an ongoing gathering of information, allowing the trainer to modify and progress a client through their integrated training program. An Integrated Fitness Profile allows the fitness professional to continually monitor a client’s needs, functional capabilities and physiological effects of exercise, enabling the client to realize the full benefit of an individualized training program.
It is important that the fitness professional understand that an Integrated Fitness Profile is not designed to diagnose any condition but rather to observe each client’s individual structural and functional status. Furthermore, the Integrated Fitness Profile presented by the National Academy of Sports Medicine is not intended to replace a medical examination. If a client exhibits extreme difficulty or pain with any observation or exercise, the fitness professional should refer the client to his or her physician or qualified health-care provider to identify any underlying cause.
What Does An Integrated Fitness Profile Tell Us?
An Integrated Fitness Profile provides the fitness professional with a three-dimensional representation of a client. It gives insight into the client’s past, present and perhaps even their future. An Integrated Fitness Profile covers information regarding habits, hobbies, movement abilities and past medical history. Essentially, an Integrated Fitness Profile allows the fitness professional to see the structure and function of a client.
By gathering information through the Integrated Fitness Profile, a fundamental representation of a client’s goals, needs and status can be created. This enables proper construction of an integrated training program that is individualized specifically for each client. When conducting an Integrated Fitness Profile, it is essential to utilize a variety of observation methods in order to obtain a balanced overview of a client (See Table 1).
|Table 1 - COMPONENTS OF AN INTEGRATED FITNESS PROFILE
- General Medical History
- Personal Data
- Gait (General Warm-up)
- Movement (Specific Warm-up)
- Movement (Workout)
Subjective information is gathered from a prospective client to give the fitness professional feedback regarding personal history such as occupation, lifestyle and medical background.
General & Medical History
Gathering personal background information about a client can be very valuable. It can help a trainer to understand a client’s physical condition and can also provide insight to what types of imbalances they may exhibit. One of the easiest forms of gathering this information is through a questionnaire.i The Physical Activity Readiness Questionnaire (PAR-Q)i is a questionnaire that has been designed to help qualify a person for low-to-moderate-to-high activity levels.ii Furthermore, it aids in identifying people for whom certain activities may not be appropriate or who may need further medical attention.
The Physical Activity Readiness Questionnaire (PAR-Q) is directed toward detecting any possible cardiorespiratory dysfunction, such as coronary heart disease (CHD). It is a good beginning point for gathering personal background information concerning a prospective client’s cardiorespiratory function, however, it is only one component of a thorough Integrated Fitness Profile. While this information is extremely important for a fitness professional, asking other questions can provide additional valuable information about a client. This includes questions about a client’s general and medical history.
Asking some very basic questions concerning a client’s history and/or personal background can provide a wealth of information. Two important areas to start are occupation and lifestyle.
A client’s occupation provides the fitness professional with an insight into what their movement capacity is and what movement patterns they perform most of their day. By obtaining this information the fitness professional can begin to recognize some important clues about the structure and ultimately the function of their client. In turn, this allows the fitness professional to begin designing an appropriate integrated training program.
Questions pertaining to a client’s lifestyle reflect what a client does in their free time or time away from work. This is generally known as their recreation and/or hobbies.
Recreation in this context refers to a client’s physical activities outside of their work environment. By finding out what recreational activities a client performs, a fitness professional can better design a program to fit these needs. For example, many clients like to golf, ski, play tennis or a variety of other sporting activities in their spare time. Thus proper forms of training must be incorporated to ensure that the client is trained in a manner that optimizes the efficiency of the kinetic chain for these activities, without predisposing it to injury.
Hobbies in this context refer to activities that a client may partake in regularly, but may not necessarily be athletic in nature. Examples include gardening, working on cars, playing cards, reading, watching television, spending time on the Internet, etc. In many of these cases, the client does not receive a lot of physical stimulation (with exception to gardening and working on cars). In these instances, it is necessary to take into account the increased demand for a properly planned integrated training program, but it may not be at the same level as someone who plays a lot of tennis for example.
Finding out a client’s medical history is absolutely crucial. Most importantly, it provides the trainer with information about any life threatening chronic diseases (CHD, high blood pressure, etc).i Furthermore, it provides information about the structure and function of the client as well. Some important areas to cover include past injuries and surgeries and chronic conditions.
Many clients coming into the fitness industry will be under the care of a medical professional and may be required to use any one of a variety of medications. It is not the role of a fitness professional to administer, prescribe or educate on the usage and effects of any of these medications. A fitness professional should always refer to the primary medical professional for information concerning a potential client and any medication they may be using.
Objective information is gathered to provide the fitness professional with forms of measurable information. This information can be used to compare beginning numbers to those measured weeks, months or years later denoting improvements in the client as well as the effectiveness of the training program. Categories include personal data (body fat and circumference measurements), posture, core and movements.
Gathering personal data on a client provides the fitness professional with measurable information specifically related to the client’s own body. Using body fat and circumference measurements to re-assess a client is often a very motivating piece of information as well as a good indication of how productive the training program has been designed.
One of the most important pieces of information that can be obtained by a fitness professional is the client’s starting body fat percentage. Body fat reduction is often the primary goal of a fitness client and this analysis can be a powerful tool to use when discussing a client’s progress. Other methods would include asking your client how their clothes are fitting, before and after circumference measurements, before and after pictures as well as something as simple as comments from friends.
Body composition can be measured a variety of ways. Depending on your tools available, the most common methods are:
- Skin fold calipers
- Bio-electrical impedance
- Underwater weighing
Circumference measurements can be another source of feedback used with clients with the goal of altering body composition. The most important factor to consider when taking circumference measurements is consistency. Measurements that can be landmarked are shown in Table 2.
Remember when taking measurements to make sure the tape measure is taut and level around the area that is being measured.
|Table 2: CIRCUMFERENCE MEASUREMENTS
||Across the Adam’s Apple
||Across the nipple line
||Half way between the acromion process and the olecranon process
||Across the naval
||Across the greater trochanter
||6 inches above the Patella
||Portion of the greatest girth, then landmark the amount of inches from the malleolus of the ankle
Every movement we produce must have a starting point or a structural base from which to generate and accept force. This is better known as posture. Posture is the independent and interdependent alignment (Static Posture) and function (Transitional and Dynamic Posture) of all components of the kinetic chain at any given moment, and is under the control of the central nervous system.iii, iv, v
A quick postural assessment can give general information regarding the state of the muscles and joints of your client. The postural assessment discussed here will be a very simplified version of an ideal assessment utilizing the Biotonix Postural Assessment System. The Certified Personal Trainer can be trained to use the Biotonix Postural Assessment device. This will enable the fitness professional to utilize current state of the art technology to accurately and objectively assess your client and give your client a print out of their deviations and an individualized corrective exercise program.
Without access to an objective postural assessment device (Biotonix System), the fitness professional will use a “snap-shot” postural assessment. The fitness professional will primarily focus on five major deviations. These include flattened feet (excessively pronated), adducted and internally rotated knees, anterior pelvic tilt, protracted shoulders and a forward head. The assessment itself can be performed in a couple minutes maximum, and may even be done while talking to your client or as they are walking toward you for their first workout.
When assessing a client's posture, look for the following indicators of bad posture:
- Flattened Feet and Externally Rotate (Excessively Pronated)
- The feet will appear flat or the client will say they have flat feet
- They will stand/walk with their feet externally rotated
- The inside (medial) portion of the foot/ankle will protrude outward on their shoe
- Adducted and Internally Rotated Knees
- The knees will have a "knock-kneed" appearance where the knees converge toward each other and are not lined up over the middle of the foot.
- Anterior Pelvic Tilt
- Often times the belt line will be a good indicator. If the belt line start higher in the back and comes down in the front, this may indicate an anterior tilt.
- A client with an anterior tilt will often have fully extended or hyperextended knees
- Protracted Shoulders
- Protracted shoulders will be detectable by the roundness across the upper back and the concavity of the chest region
- The shoulders may also appear to point in an anterior direction
- The palm of the hand may be facing posteriorly or away from a front view of the client
- Forward Head
- A forward head will sit anterior (forward) to the shoulder and often exhibit a protruding chin.
If you have a difficult time seeing anything right away, don’t worry. Later in this article series we will discuss dynamic postural observations that make this process much easier. We will also provide a clear understanding of what may lead to these postural deviations as well as how to address them.
Integrated Fitness Profile
What is your current occupation? ______________________
- Does your occupation require extended periods of sitting? Y or N
- Does your occupation require extended periods of repetitive movements? Y or N
- Does your occupation require you to wear shoes with a heel (dress shoes)? Y or N
- Does your occupation cause you anxiety (mental stress)? Y or N
- Do you partake in any recreational activities (golf, tennis, skiing, etc)? Y or N
- Do you have any hobbies (reading, gardening, working on cars, Internet, etc)? Y or N
- Have you ever had any pain or injuries (ankle, knee, hip, back, shoulder, etc)? Y or N
- Have you ever had any surgeries? Y or N
- Has a medical doctor ever diagnosed you with a Chronic Disease such as Coronary Heart Disease (CHD) or Coronary Artery Disease (CAD), Hypertension (high blood pressure), High Cholesterol, Diabetes, etc? Y or N
- Are you currently taking any medication? Y or N
- What goals are most important for you to accomplish with a training program?
- How many times per week are you willing to work out with a trainer? _______
- Are you willing to perform home flexibility or workout routines? Y or N
- How many times per week are you willing to work out on your own? _______
|Body Fat ______%
||Body Fat ______%
||Body Fat ______%
||Body Fat ______%
- American College of Sports Medicine. ACSM’s guidelines for exercise testing and prescription. 5th edition. Philadelphia: Williams & Wilkins; 1995.
- Thomas S, Reading J, Shephard RJ. Revision of the Physical Activity Readiness Questionnaire (PAR-Q). Can J Sports Sci 1992; 17:338-345.
- Kendall FP, McCreary EK, Provance PG. Muscles testing and Function. 4th edition. Baltimore, MA: Lippincott Williams & Wilkins; 1993.
- Norkin CC, Levangie PK. Joint structure and fFunction. 2nd edition. Philidelphia, PA: F.A. Davis Company; 1992.
- Soderberg GL. Kinesiology. 2nd edition. Baltimore, MD: Williams & Wilkins; 1997.