Chapter 12- ACE IFT in practice

Question 1

SHARON:
33 yr old female
Used to be a recreational runner for 5K and 10K prior to her pregnancies
Played on a coed soccer team
Has two children under the age of four
Used to work out in group settings and exercised through pregnancy
Suffered a knee sprain in college, and has occasional lower back pain
Her goal is to “get back into pre-pregnancy shape”

Answer 1

*In “preparation” stage of change
*Health History Questionnaire
*Trainer admisnisters basic Posture Assessment-she has slight kyphosis and low back lordosis
*Trainer starts her out with phase one of cardio respiratory training to build the aerobic base. He performs the submaximal talk test to determine VT1
*Trainer assesses her lower body flexibility and strength and endurance of core muscles to try to figure out the source of her low back discomfort
*He conducts the Thomas test, Trunk Flexor, Trunk Lateral and Trunk Extensor endurance tests
* Trainer takes body composition measurements because of Sharon’s goal
*Based off of the test, Sharon has slight kyphosis and lordosis posture. Her right leg has more ROM And she’s tight in both quadriceps. Her left hip flexors are tighter than the right which could be contributing to her back soreness. Based off of the trunk tests, she needs to work on strength and endurance of her back extensor muscles. She also has a slight imbalance in her core strength that needs to be fixed.
Phase 1: The trainer starts her out with phase one of both movement and resistance training, and cardiorespiratory training. (Stability and mobility & aerobic base respectively)
*Once Sharon can complete the stability and mobility exercise circuit three to four times with good coordination she will progress to phase two (movement training) Likewise, once Sharon is consistently performing 25 to 30 minutes of consistent cardio, the trainer will have her move into phase 2 (aerobic efficiency) where he will determine VT1 and slowly introduce low zone intervals.
Phase 2: Sharon will be in phase two of movement and resistance training until she demonstrates efficient control of the five primary movements. Sharon will likely stay in phase two of cardia respiratory training. She will be preparing for an upcoming 5K in this phase. The trainer will continue to progress intervals of different intensities and reassess her HR at vt1.

Question 2

DAVID:
57 yr old male
Avid runner, cyclist, golfer
His job can make it difficult to maintain a schedule
has occasional muscle and joint soreness, but has been experiencing recent pain in his back and knee
He checked with his doctor and received full medical clearance to exercise
his goal is to improve his golf game and prepare for a hundred mile bike ride event

Answer 2

• Trainer used Health Risk Appraisal Form
• David is determined to be in the maintenance stage of change because He has been a long time regular exerciser.
• Because of his goal to improve at his golf game the trainer decides to use assessments to assess his flexibility and identify any muscle imbalances
• Trainer uses a hurdle step test and a postural assessment to assess muscle imbalances and overall postural instability. Trainer also uses Apley’s scratch test and thoracic spine mobility test to identify potential upper extremity mobility issues. The passive straight leg raise and Thomas test will identify mobility issues in the lower body. Core endurance tests will assess David’s core fitness. Finally the trainer will administer the submaximal talk test using a stationary bike to determine HR at VT1.
• The test determined that David had postural and core instability, and also flexibility issues. He did however have great cardio respiratory fitness.
• Because David did not identify weight loss as one of his goals the trainer decided to design an exercise program that will increase cardio respiratory fitness for cycling, and enhance his golf specific strength and flexibility
• The trainer decides to start David and phase one of movement and resistance training (stability and mobility). He will train in this phase until he demonstrates effective strength in his core and improved ROM in hips

Question 3

STANLEY:
28 yr old male software designer
Enjoys playing interactive video games at night
Otherwise sedentary, no history of adhering to an exercise program
Struggles with ADL
At risk for metabolic syndrome
Goal is to lose weight and improve function, stop smoking, eat better, and develop better methods for stress management
In preparation stage of change

Answer 3

• Trainer gave Stanley health risk appraisal, and had Stanley sign a liability waiver and informed consent
• trainer does not subject him to fitness assessments that will only reaffirm his current lack of fitness
• Trainer discusses how proper nutrition and diet will help Stanley achieve weight loss goals but does not recommend a specific diet

Question 4

MEREDITH:
64 yr old grandmother
She’s active, walker, aquatic exercises, playing with grandkids
Very competitive, in tennis league
Sore knees
Has osteoarthritis in her knees and hips
Goal is to establish regular exercise program to improve health, lose weight, minimize arthritis effects, and get back into shape for competitive tennis

Answer 4

• Trainer used following assessments as well as a health risk appraisal: upper and lower body flexibility, core muscular endurance, submaximal talk test to determine HR at VT1
• Test results showed asymmetrical ROM between right and left rotation, Also asymmetrical ROM between right and left shoulders, asymmetrical flexibility and hips and knee extensors
• Trainer will start Meredith and Phase 2 of movement and resistance training (movement) due to good core stability and joint mobility during initial assessments. she will work in his face until she demonstrates good strength and control through the movement patterns
• Trainer will start Meredith and Phase 2 of cardio respiratory Training (aerobic efficiency) because she has maintained her aerobic fitness through walking in aquatic exercise. to protect her niece she will perform most of her training on an elliptical or stationary bike
• After demonstrating coordination with the basic movements the trainer will progress Meredith to phase three of movement and resistance training (load). She will need to increase muscular strength and endurance to help her achieve her goal of winning and competitive tennis. She will stay in this face until she has made significant gains and is ready to progress to performance training
• Meredith progresses to Phase 3 of cardio respiratory Training (anaerobic endurance). Trainer recommends intervals with 2 minutes in zone 2, followed by 4 minute recovery intervals and zone 1. After working up to four of the intervals, Meredith progresses but first decreasing the recovery interval to 3 minutes, then decreasing the recovery interval to 2, and then increasing both the work and recovery interval to 3 minutes for a set of four intervals.
• After 7 weeks Meredith feels like she has her old fitness level back. The trainer progresses her to face four of movement and resistance training (performing). He will keep her in this face for the two months leading up to the start of the tennis competition and maintain intensity for the direction of the season, usually 3 months long

Question 5

KELLY:
30 yr old preparing for wedding that is 4 months away
She exercises sporadically and usually makes excuses to not go to gym
She’s generally comfortable with her body
She wants to lose weight, but she fears that strength training will bulk her up

Answer 5

• Kelly is in the preparation stage
• The trainer has separated her program into two distinct phases that will address her total body strength with an emphasis on the back, shoulders, and arms because she’s wearing off the shoulder dress for her wedding
• The trainer uses a health risk appraisal in conjunction with assessments for posture and hip mobility. He also measures her body composition and waist to hip ratio.
• Test results show Kelly stands with lordosis posture, and she needs to improve flexibility and extensibility in both of her hip flexors
• The trainer starts Kelly and Phase 2 of movement and resistance training (movement) and expect her to be in this phase for 6 weeks at which point he will progress her to the next base so she can focus on muscular development. Most of her exercises are primarily body weight.
• Kelly is very motivated to work out and actually completes 4-5 sessions separate from personal training sessions on her own. During her own sessions she does group fitness classes and uses cardiovascular machines. So the trainer does not utilize cardiorespiratory training for her at all since she does it on her own.
• Kelly makes great progress and enjoys resistance training. She has also been very consistent. When she has completed 4 weeks of movement training, the trainer progresses her to phase 3 of movement and resistance training (load).
• Kelly works in Phase 3 until her wedding and at the completion of 12 weeks of load training she looks lean and fit. She has lost 5% body fat, 2-in off her waist, and 3-in off of her hips and is feeling confident for her big day.