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ACE Personal Trainer

Manual, 4th edition


Chapter 1:
Role and Scope of Practice
for the Personal Trainer
1

Introduction
The human body responds to the stress of physical movement with
improved fitness and health.
2008 Physical Activity Guidelines for Americans (U.S. Department of
Health & Human Services)
Regular physical activity reduces the risk of many adverse health outcomes.
For most health outcomes, additional benefits occur as the amount of physical activity
increases.
Most health benefits occur with at least 150 minutes a week of moderate-intensity
physical activity, such as brisk walking.
Both aerobic and muscle-strengthening activity are beneficial.
Health benefits occur across all population groups.
The health benefits of physical activity occur for people with disabilities.
The benefits of physical activity far outweigh the possibility of adverse outcomes.

Personal Trainer
Healthcare professional who works to make
safe and effective exercise programs for
apparently healthy clients.

Personal Trainer
Responsible for designing a comprehensive
exercise program to meet an individuals needs
and goals while also considering a persons health
history
Become an incredibly fast growing and expansive
field
Work with all types of individuals

Providing increasing services in post-rehabilitation


training, sports conditioning, special medical
needs, and weight management

The Role of Fitness Professionals


The role of fitness professionals in relation to the other members of
the healthcare team is presented on the following slide.
The personal trainer should obtain written permission from the
client to communicate with the referring physician.
Even when clients do not have a physicians referral, it is important
for the personal trainer to maintain confidential records that
include the clients:
Program
Progress
Health-history information

No single standard qualification for a person to


practice as a personal fitness trainer
Most organizations have specific requirements,
mandatory testing/retesting, renewal periods, and
continuing education
Some even require a formal educational degree in
exercise science or another related field

primary organizations

American College of Sports Medicine (ACSM)


National Academy of Sports Medicine (NASM)
National Strength and Conditioning Association (NSCA)
American Council on Exercise (ACE)
National Council on Strength & Fitness (NCSF)
National Exercise Trainers Associaton (NETA)
International Fitness Association (IFA)

Specialty Areas Within Allied Healthcare


Figure 1-1

The ACE Personal Trainer Certification

Candidates must meet or surpass a level of


minimum competency as assessed by a
competency-based evaluation (exam) to show that
they are adequately qualified to work in the
profession.
The primary purpose of a certification is to protect
the public from harm.
An ACE-certified Personal Trainer has proven
competence in:
Making safe and effective exercise-programming
decisions in a variety of practical situations
Minimizing client risk and exposure to harm

Defining Scope of Practice


A scope of practice defines the:
Legal range of services that professionals in a given
field can provide
Settings in which those services can be provided
Guidelines or parameters that must be followed

The laws, rules, and regulations that govern a


profession are established for the protection of
the public.
Fitness professionals as a collective group have a
general scope of practice, as presented on the
following slide.

General Scope of Practice

Fitness Professionals DO NOT:

Fitness Professionals DO:

Diagnose

Receive exercise, health, or nutrition guidelines from a physician, physical therapist, registered dietician, etc.
Follow national consensus guidelines for exercise programs for medical disorders
Screen for exercise limitations
Identify potential risk factors through screening
Refer clients to an appropriate allied health professional or medical practitioner

Prescribe

Design exercise programs


Refer clients to an appropriate allied health professional or medical practitioner for an exercise prescription

Prescribe diets or recommend


specific supplements

Provide general information on healthy eating, according to the MyPyramid Food Guidance System
Refer clients to a dietician or nutritionist for a specific diet plan

Treat injury or disease

Refer clients to an appropriate allied health professional or medical practitioner for treatment
Use exercise to help improve overall health
Help clients follow physician or therapist advice

Monitor progress for medically


referred clients

Document progress
Report progress to an appropriate allied health professional or medical practitioner
Follow physician, therapist, or dietician recommendations

Rehabilitate

Design an exercise program once a client has been released from rehabilitation

Counsel

Coach
Provide general information
Refer patients to a qualified counselor or therapist

Work with patients

Work with clients

Table 1-2 page 8

Scope of Practice for ACE-certified Personal Trainers

ACE-certified Personal Trainers must work


within their defined scope of practice (as
presented on the following slide) to:
Provide effective services to their clients
Gain and maintain support from the healthcare
community
Avoid the legal ramifications of providing services
outside their professional scope

ACE-certified Personal Trainer Scope of Practice


Figure 1-2 page 9
The ACE-certified Personal Trainer is a fitness professional who has met all requirements of the American Council on Exercise to
develop and implement fitness programs for individuals who have no apparent physical limitations or special medical needs.
The ACE-certified Personal Trainer realizes that personal training is a service industry focused on helping people enhance
fitness and modify risk factors for disease to improve health. As members of the allied healthcare continuum with a primary
focus on prevention, ACE-certified Personal Trainers have a scope of practice that includes:
Developing and implementing exercise programs that are safe, effective, and appropriate for individuals who are apparently
healthy or have medical clearance to exercise
Conducting health-history interviews and stratifying risk for cardiovascular disease with clients in order to determine the
need for referral and identify contraindications for exercise
Administering appropriate fitness assessments based on the clients health history, current fitness, lifestyle factors, and
goals using research-proven and published protocols
Assisting clients in setting and achieving realistic fitness goals
Teaching correct exercise methods and progressions through demonstration, explanation, and proper cueing and spotting
techniques
Empowering individuals to begin and adhere to their exercise programs using guidance, support, motivation, lapseprevention strategies, and effective feedback
Designing structured exercise programs for one-on-one and small-group personal training
Educating clients about fitness- and health-related topics to help them in adopting healthful behaviors that facilitate
exercise program success
Protecting client confidentiality according to the Health Insurance Portability and Accountability Act (HIPAA) and related
regional and national laws
Always acting with professionalism, respect, and integrity
Recognizing what is within the scope of practice and always referring clients to other healthcare professionals when
appropriate
Being prepared for emergency situations and responding appropriately when they occur

Working Within the Scope of Practice


Personal trainers should never provide services
that are outside their defined scope of practice.
Overlap exists among professions within the
healthcare field.

Working With Other Healthcare Professionals

A personal trainer should not make


recommendations that contradict those of the
clients healthcare team.
Each state, province, and country has specific
laws about the responsibilities of different
healthcare professions.
It is the responsibility of the personal trainer to:
Learn and adhere to the laws in his or her
geographical area
Work within the ACE-certified Personal Trainer scope
of practice and adhere to the ACE Code of Ethics

Knowledge, Skills, and Abilities


The ACE Personal Trainer Certification is designed
for fitness professionals wanting to provide oneon-one and small-group exercise instruction to
apparently healthy individuals.
The certification program is continually evaluated.
The outline of tasks, knowledge, and skills is
published as the ACE Personal Trainer Exam
Content Outline
Published as Appendix B in the ACE
Personal Trainer Manual, 4th ed.
Found on the ACE website at:
www.acefitness.org/getcertified/aboutexam_pt.aspx

ACE Code of Ethics


Appendix A

ACE-certified Professionals are guided by the following principles of conduct as they


interact with clients/participants, the public, and other health and fitness
professionals.
ACE-certified Professionals will endeavor to:
Provide safe and effective instruction
Provide equal and fair treatment to all clients
Stay up-to-date on the latest health and fitness research and understand its
practical application
Maintain current CPR certification and knowledge of first-aid services
Comply with all applicable business, employment, and intellectual property
laws
Maintain the confidentiality of all client information
Refer clients to more qualified health or medical professionals when
appropriate
Uphold and enhance public appreciation and trust for the health and fitness
industry
Establish and maintain clear professional boundaries

Client Privacy
Clients will share confidential information with
the personal trainer.
To help prevent violations of client privacy,
ACE-certified Professionals should adhere to
the Health Insurance Portability and
Accountability Act (HIPAA).
Following HIPAA regulations can help maintain the
confidentiality of each clients protected health
information.

Referral
Personal trainers must refer clients who
require services outside their scope of
practice.
Proper referral ensures that clients are
provided with appropriate care from qualified
providers.
Referrals can also come to the personal trainer
from other health professionals.

Developing a Referral Network


Trainers should identify allied health professionals who are
reputable.
Potential referral sources include:
Mind/body instructors
Smoking cessation programs
Aquatic exercise programs
Support groups
Massage therapists
Research instructors, programs, or organizations before
recommending any programs or services to a client.
With proper networking, the personal trainer may also gain
referrals from the other health and fitness professionals
within the network.

Safety
All fitness professionals should do what they can to minimize risk for
everyone in the fitness facility, including:

Proper equipment maintenance and storage


Ensuring appropriate cleanliness of the facility
Understanding emergency procedures
Conducting a health-history assessment
Determining appropriate levels of intensity for initial exercise program design
Helping clients perform exercises in a safe and effective manner with proper
progressions

Even with the best risk-management program, injuries and incidents can
still occur.
As such, ACE recommends that all ACE-certified Professionals carry professional liability
insurance.

Supplements
Supplements are not regulated by the U.S. Food
and Drug Administration (FDA).
It is not illegal for fitness facilities to sell
commercial nutritional supplements.
However, it is irresponsible for them to provide
supplement recommendations without the
appropriate staff to give such advice.

Personal trainers are not qualified to recommend


supplements to clients.
Unless a personal trainer is also a registered
dietitian or a physician, he or she does not have
the expertise or legal qualifications necessary to
recommend supplements.

Educating Clients About Supplements


Personal trainers should educate themselves
about supplements.
The personal trainer should help the client
understand that:
Fitness goals can be reached without supplements
Supplements can have negative and potentially
harmful side effects

Some clients insist on using dietary supplements.


The personal trainer should refer the client to a
qualified physician or registered dietitian for
guidance.

Ramifications of Offering
Inappropriate Services

Offering services that are within the legal


realm of other healthcare professions are in
violation of the ACE Code of Ethics.
The client scenarios on the following slide
provide examples of services that are within
and outside the scope of practice.

Appropriate Scope of Practice

Table 1-3 page 15

Negligence

Failing to perform as a reasonable and prudent person would under similar


circumstances is considered negligence.
In the case of personal trainers, a reasonable and prudent person is someone who
adheres to the established standard of care.
Since standards of care can and do change, it is critical that personal trainers stay
abreast of new guidelines through continuing education.
A negligent act can occur if a trainer fails to act (act of omission) or acts
inappropriately (act of commission).
To substantiate a charge of negligence in court, the plaintiff must establish four
elements:

The defendant had a duty to protect the plaintiff from injury


The defendant failed to uphold the standard of care necessary to perform that duty
Damage or injury to the plaintiff occurred
This damage or injury was caused by the defendants breach of duty (proximate causation)

Vicarious Liability and Waivers

Vicarious liability (also known as respondeat superior) means that employers are
responsible for the employment actions of their employees.
If an employee is negligent while working within the normal scope of employment,
it is likely that the injured party will sue not only the employee, but also the
employer or employers.
The use of waivers is critical in personal training, as a properly worded exculpatory
clause bars the injured from potential recovery.
There are some potential issues that every personal trainer must investigate with
an attorney prior to crafting a waiver.

State-specific validity
Types of activities and potential risks of injury that would be barred from recovery

Waivers typically do not protect the personal trainer from injuries directly caused
by gross negligence.

Agreements to Participate, Informed Consent, and Waivers

Personal trainers should understand the use of


agreements to participate, informed consent, and
waivers.
They can be important defenses in litigation for
negligence.

Ideally, each of these forms should be printed


(avoid handwritten agreements) and signed by all
clients before beginning the first exercise session.
Before a personal trainer begins using any of
these documents, it is critical that legal counsel
specializing in health and fitness in the personal
trainers state be consulted.

Agreement to Participate
Personal trainers should have a process to formally warn their
clients about the potential dangers of exercise.
An agreement to participate serves to demonstrate that:
The client was made aware of the normal outcomes of certain types of
physical activity
The client willingly assumed the risks of participation

The agreement to participate should detail:


Nature of the activity
Potential risks to be encountered
Expected behaviors of the participant

Typically, agreements to participate are incorporated into other


documents, such as informed consent forms and waivers.

Informed
Consent
An informed consent form can be utilized to demonstrate that a
client acknowledges that he or she has been specifically informed
about the risks associated with the activity in which he or she is
about to engage.
Client gives consent to participate in an exercise program and/or have
something done to him or her by the personal trainer (e.g., fitness
assessments), and therefore can differ slightly from an agreement to participate
Primarily intended to communicate the potential benefits and dangers of the
program or exercise testing procedures to the client
Should detail the possible discomforts involved and potential alternatives

The informed consent form, combined with oral communication,


prepares the client for the positive and negative effects of certain
types of exercise.

Procedures

Valid agreements to participate, informed consent forms, and waivers


must be administered properly to clients.
Minors cannot legally sign a contract, so in most cases a waiver signed by a
child will be invalidated by the courts.
Personal trainers should remember to have every member of a family sign
an individual waiver.
The personal trainer should
retain the paperwork on file
at least until the statute of
limitationsthe time allotted
to sue for damages
has elapsed.

Legal Responsibilities
The personal trainer should prepare for each
training session with safety as the first priority.
This provides a better experience for the client
and increases the likelihood that the client will
continue to utilize the trainers services.

An inspection of facilities and equipment and


a review of the protocols regarding
supervision and instruction should be
regularly performed.

Facilities
Personal trainers have an obligation to ensure that the facilities used are
free from unreasonable hazards.
At the very least, the physical environment should be inspected each day
prior to beginning any training session.
The inspection should consider the following issues:
Trainers should ensure that floor surfaces will cushion the feet, knees, and legs from
excessive stress.
There should be sufficient free space available to protect the client from other patrons
and from hurting him- or herself on equipment.
Functional lighting must be sufficient for chosen exercises.
There must be functional heating and air conditioning systems.
Proximity to drinking fountains and bathrooms is important for some clients.

Use of Public Spaces


In some jurisdictions it is illegal to train clients on public beaches, parks, or
trails.
It is the trainers responsibility to know the local laws prior to using these areas.

Once a legal outdoor area has been selected for a training session, the
trainer should understand the potential dangers of the area.
Weather
Potential acts of God

It is the trainers responsibility to


that the activities will not pose
clients.

ensure
a significant risk for

Equipment
All equipment should meet the highest safety and design standards and
should be purchased from a reputable manufacturer.
Equipment must be regularly inspected and properly maintained.
Protocol for broken equipment
Once something is deemed unsafe, the personal trainer should immediately remove the
equipment from the training area.
If quick removal is not feasible, the equipment should be disabled to prevent further use
until repaired.
Do not use signs easily fall off and unsuspecting patrons may be injured when trying to
use the broken equipment.

Manufacturers typically provide maintenance schedules for equipment.

Supervision
General supervision
Overseeing a group of people, such as when a group fitness instructor
leads a large class
Specific supervision
Occurs when an individual is supervised while performing a specific
activity, such as what typically occurs during a personal-training
session
A trainer should never leave a client when there is a potential for injury.
Trainers who work with two or more clients should design the workouts to
alternate between activities requiring general and specific supervision.
Trainers should eliminate any time that a client is not in their direct view.
Before beginning any session, the trainer must adequately plan for any
emergencies that may arise.
Personal trainers should also be aware of the actions of their employees.

Instruction
Personal trainers should utilize instructional techniques
that are consistent with current professional practices.
Proper instruction also means individualizing workout
routines for each client.
Personal trainers should insist on proper use of
equipment and performance of activities at all times.
Trainers should avoid touching clients unless it is
essential for proper instruction.
Clients should be informed about the purpose of potential
touching before it occurs.
If a client objects, an alternative exercise should be
utilized.

Safety Guidelines

Be sure that all sessions are well-planned, appropriate, and documented.


Communicate and enforce all safety rules for equipment use.
Ensure that equipment meets or exceeds all industry standards.
Inspect all equipment prior to use and document adherence to
maintenance schedules.
Never allow unsupervised activity by the client.
Limit participation to those under contract.
Clearly warn clients about the specific risks of planned activities.
Only select activities within the defined scope of practice and appropriate
areas of expertise.
Ensure that clients wear any necessary protective equipment.
Review the emergency plan [access to a phone and 911 for emergency
medical services (EMS)].
Stay up-to-date with certifications and education in the field.

Liability Insurance
Even after taking precautions, personal trainers should obtain professional
liability insurance.
ACE recommends retaining at least $1 million in coverage, as medical
expenses can easily cost hundreds of thousands of dollars.
The American Council on Exercise has established relationships with
reputable insurance carriers who specialize in the fitness industry.
Visit www.acefitness.org/pdfs/personal-trainer-insurance.pdf for more
information.
Owners who will use their own homes or clients homes should ensure
that a specific insurance rider will cover those activities.
Specific language should provide liability protection for trainers who utilize
outdoor settings for their training activities.
For trainers who own their own fitness clubs, insurance should be retained
that covers potential problems with the facility as well as the instruction
and supervision of the trainer.

Employees and Independent


Contractors
Many fitness employers now require their employees
to demonstrate proof of liability insurance when they
are hired.
Employers should ensure that employees renew and verify
their policies annually.
Potential employees may wish to verify that the fitness
center has adequate coverage.

Independent contractors must maintain adequate


insurance.
The employment or independent contractor
agreement between the fitness center and the
personal trainer should contain language detailing
insurance requirements and responsibilities.

Other Business Concerns With Legal Implications

Personal trainers must be aware of the


implications of other potential legal issues,
including those related to:
Marketing activities
Intellectual property
Transportation
Financing

Marketing Activities
Unfortunately, it has become common for some
fitness centers to utilize improper marketing
tactics to attract and retain clients.
Personal trainers should understand the
marketing and operating activities that their
fitness centers may utilize.
If a fitness center is behaving unethically or
illegally, the personal trainer may be associated
with those practices.
Trainers should only associate with fitness facilities
that maintain high legal and ethical standards.

Intellectual Property
Music recordings and television programming
sold commercially are intended strictly for the
private, noncommercial use of the purchaser.
In many cases, copyright violations occur when a
fitness center utilizes music or television broadcasts.

ASCAP and BMI issue licenses for the commercial


use of broadcasts and recordings, but their fees
may be prohibitive.
A good option is to purchase recordings produced
specifically for use in fitness facilities.

When training clients in their homes, personal


trainers can have clients provide the music for
each session.

Transportation
In most cases, personal trainers will meet their
clients at a fitness center or some other location.
There may be a situation where the personal
trainer provides transportation for the client to or
from a training session.
Trainers should be aware that many standard
automobile insurance policies may not cover injuries
sustained by clients riding in the trainers vehicle.

If the trainer is going to provide a ride to a client,


the trainer should check his or her auto insurance
policy to ensure that potential injuries from
accidents are covered.

Financing
As personal trainers create and expand their
businesses, they may need to seek financing for certain
activities.
Banks and other lenders usually will only loan money if
it is personally guaranteed by an individual.
Unfortunately, many companies have advertised
business loans that are in fact personal loans.
Personal trainers who thought that only their businesses
were liable for the financial obligation later learned that
the lender was able to pursue the trainer for unpaid debts.
Trainers should read and understand the fine print of
any loan prior to signing.

Assessing Identified Risks


The personal trainer must review each risk, with consideration given to
the probability that the risk could occur and, if so, what would be the
conceivable severity.
The table below can be used to assess the identified risks.

Summary
In providing quality personalized fitness instruction, legal and
business concerns are of paramount importance.
Ultimately, it is the personal trainers responsibility to
thoroughly understand the legal guidelines that must be
followed to create a safe and enjoyable environment for
clients.