WHAT IS FUNCTIONAL/NEUROMOTOR
FITNESS?
by Leslie Stenger, M.S.
Downloaded from https://journals.lww.com/acsm-healthfitness by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3JvjgSxPcaSJxkHyXLDE91+AGUfk7X+Dgv6arJ2rd11EhaET8sglb1A== on 03/04/2019
Apply It!
Functional training is a broad and
confusing concept because of the
multitude of definitions and appli-
cations. The aim of this article is
to:
1) review the multitude of defini-
tions for functional fitness from
respected health and fitness
professionals.
2) translate the complexities of
functional fitness into context for
practical application by health and
fitness professionals.
3) apply general programming
guidelines to the development of
a functional neuromotor program.
Key words: Functional Training,
Functional Movement, Functional
Exercise, Integrated Movement,
Purpose-Driven Training
Volume 22 | Number 6
Copyright © 2018 American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
A
sk five health and fitness professionals to define functional training, and it is
very likely you’ll get five distinct and different definitions. Chances are
there’ll be some similarities, yet at the same time some interesting differ-
ences. How can that be? Think about the factors that influence your re-
sponse when you are asked the question, “What is functional training?” It is
one of the most misunderstood terms in the industry, and the reason is simple. The term
functional training originated in sports medicine and, more specifically, in rehabilitation
clinics. Early definitions focused on rehabilitation to enhance or develop the skills associ-
ated with activities of daily living (ADLs) and, frequently, when working with older adults
(1,2). Functional training then moved into the coaching arena through athletic training
and followed into training facilities where athletes and average individuals were
exposed to a plethora of methods associated with functional training. According to
DaSilva-Grigoletto et al., functionality from the perspective of the physical therapist is
based on a prescription of neuromuscular conditioning aimed at the development
and maintenance of ADLs (3). In this context, the desired outcome is rehabilitative
in nature to restore function. Strength and conditioning coaches working with athletes
use the term to reflect the type of programming that will enhance sport performance.
Personal trainers working with clients use the concept to reflect a variety of outcomes
such as enhanced movement patterns, motor skills, occupational skill, or improvement
in one or more fitness components (strength, cardiorespiratory, flexibility, muscular
endurance). The development of a functional training program starts by defining the
desired outcome of the program rather than developing a program based upon a
packaged fitness assessment. This unique way of looking at a concept requires the
health and fitness professional to look at programming from a backward design, which
will be discussed later. Your perception (i.e., your experience, knowledge, and
education) and your specialization (i.e., personal trainer, exercise specialist, coach, etc.)
usually dictate your answer to the question “what is functional training?” No doubt,
your perception is the lens through which you view the concept of functional training.
Two fitness professionals could watch an individual perform a functional training
exercise and “see” the performance outcome differently, a perspective based on their
own experiences. These two factors, experience and specialization, influence how
functional training is individually defined.
There are two factors that influence your response when you are
asked to define functional training: your perception, which results
from experience, knowledge, and education, and your own
specialization in the field.
www.acsm-healthfitness.org 35
FUNCTIONAL FITNESS: DEFINITIONS AND TRENDS
Specialization influences the desired outcome
of a field that has been divided into three
professions: strength and conditioning,
personal training, and physical therapy. These
three professions have merged into what is now
referred to as a performance specialist.
A performance specialist offers services to
individuals that participate in active
occupations such as the military, firefighters,
police, emergency medical personnel, etc.
Functional training aligns with active
occupations that can benefit from training that
is specific to the skills that transfer to the
efficient movement patterns associated with
the specific job.
ACSM WEIGHS IN
Each year since 2007, ACSM has conducted a worldwide survey
of health and fitness professionals to determine the top fitness
trends for the year. A summary of the survey results has been pub-
lished in ACSM’s Health & Fitness Journal® for each of the past
12 years. Functional training has appeared in the top 10 trends
in 9 of the 12 years and in the top 20 all 12 years. For the purposes
of the survey, functional training is defined as using strength train-
ing to improve balance, coordination, force, power, and endur-
ance to enhance one’s ability to perform ADLs (4).
36 ACSM’s Health & Fitness Journal ®
Copyright © 2018 American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
Over the years, functional training has been expressed in a
variety of ways, and it is beneficial to review some of the defini-
tions from professionals who have spent their careers in the
health and fitness industry. The professionals I chose to highlight
in this article have a wealth of experience and knowledge in the
health and fitness field. You’ll note that their area of specializa-
tion may influence their own individual lens and definition of
functional training as depicted in Table 1 and Table 1a.
After reviewing a multitude of definitions for functional
training, the most simplistic and intuitive is described by noted
strength and conditioning coach Mike Boyle as “Function is,
essentially purpose. Functional training can therefore be described
as purposeful learning” (1). What separates functional training
from other forms of training is that it is individualized, and the
general outcome is improved movement. The following is a list
of common themes associated with functional training:
• Purpose-driven
• Intentional
• Multiplanar/Multijoint
• Real-life activities
• Specific
• Task-driven
• Injury prevention
• Chain reaction with body
• Individualized program
• Integration
• Real-life activities
The terms functional training and functional fitness are fre-
quently used interchangeably, yet the terms training and fitness
are not the same. Merriam-Webster defines fitness as “the condition
of being physically fit and healthy or the quality of being suitable
to fulfill a particular role or task.” Whereas, training is defined as
“the skill, knowledge, or experience acquired by one that trains”
(5). That leaves us with the term functional, which is defined as
“something used to contribute to the development or maintenance
of a larger whole.” Prominent sports scientist and biomechanist,
Mel Siff, defines functionality as the following:
November/December 2018
TABLE 1: Functional Training From Key Health and Fitness Professionals
Professional
Mike Boyle (1)
Paul Check (24,25)
Gray Cook (23)
Vern Gambetta (26)
Gary Gray (14)
Juan Carlos Santana (27)
Nick Tumminello (13)
Definition of Functional Training/Movement/Exercise(s) Specialization Web site
An exercise continuum involving balance and Strength and www.bodybyboyle.com
proprioception, performed with the feet on the conditioning
ground and without assistance of machines, such
that strength is displayed in unstable conditions
and body weight is managed in all movement planes.
Functional exercise is a means to an end by training Holistic health www.chekinstitute.com
movement patterns that are essential to your work educator
or sports environment. The program must consider
the desired outcome on all primary physiological
systems of the body while considering the emotional,
mental, and spiritual component of the human being.
Patterns and sequences remain the preferred mode Physical therapy www.functionalmovment.com
of operation in biological organisms. Place the www.graycook.com
emphasis on movement patterns to let the body
parts develop naturally.
Functional training involves more than working on Strength and www.gambetta.com
unstable surfaces and using stability balls and stretch conditioning
cords. It encompasses a range of method and
applications that aid in the transfer to training to
competition and is open to innovation. It involves
movement of multiple body parts in multiple planes.
Function can be defined and applied by observing Physical therapy www.grayinstitute.com
the Physical, Biological, and Behavioral Sciences.
Therefore, function is scientific, yet it is also
individualized, similar to our fingerprints. What is
functional from one individual to the next may, more
often than not, differ.
Functional training focuses on the movement Performance www.ihpfitness.com
function of the human body as classified by the specialist
four pillars of movement: locomotion, level changes,
pushing, pulling, and rotation. Train body movements
that are performed every day. A spectrum of
activities that condition the body consistent with
its integrated movement.
Functional training is all about transfer into your Personal trainer www.nicktumminello.com
specific movement task and specific training goal
(i.e., the purpose of why you’re training). If the
exercise transfers positively into the target sport,
activity or physique goal you’re training for, it’s
functional.

“Functionality depends not only on the exercise itself but on
many other factors, such as the pattern of execution, the charac-
teristics of the athlete, reps, and sets, the manner of execution,
the phase of training, interaction with other training, the current
physical and mental state of the athlete, the overall training
program, and several other variables” (6).
Over the course of time, there have been many derivatives of
the term functional training. Many definitions are used synony-
mously because there are common terms and ideas within the
definitions as reviewed in Table 2.
Volume 22 | Number 6
There are two other terms that have very distinct definitions and
should not be used interchangeably with functional training: correc-
tive exercise and sport-specific training. Eric D’Agati, a Functional Move-
ment Systems trainer, describes the difference by explaining
corrective exercises as being designed to correct an imbalance or
dysfunction found in a movement. Whereas, functional exercises
reinforce the movement once the corrective exercise has been
applied (7). Mike Boyle describes sports-specific training as activities
that often mimic the exact skill associated with the sport. It may
incorporate exercises that are general in nature but will be used
www.acsm-healthfitness.org 37

Copyright © 2018 American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
FUNCTIONAL FITNESS: DEFINITIONS AND TRENDS
through participation in the sport (1). The goal of functional train-
ing is not to mimic movement requirements of sport, such as the
serve in tennis. Instead, the focus is to train the various movement
patterns that will enhance the specific skills associated with the
tennis serve such as rotation through multiple planes.
SPECIALIZATION IDENTIFIED
Specialization influences the desired outcome of a field that has
been divided into three professions: strength and conditioning,
personal training, and physical therapy. According to Mike
Boyle, the three specializations, to some degree, have merged
into what is now referred to as performance development or
enhancement, and the professionals are now known as perfor-
mance specialists (1). In many instances, these performance
38 ACSM’s Health & Fitness Journal ®
Copyright © 2018 American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
TABLE 1A: Common Reference to Functional Training
"Function is, essentially, purpose" -Mike Boyle-
"Train, not drain" -Paul Check-
"First Move Well–Then Move Often" -Gray Cook-
"Train Movements Not Muscles" -Vern Gambetta-
"Movement Follows the Path of Least Resistance" -Gary Gray-
"Functional Training is about movement not the machines or
equipment" -Juan Carlos Santana-
"Functional training is all about transfer into your training
goal(s)!" -Nick Tumminello-
specialists will offer services to individuals that participate in active
occupations such as the military, firefighters, police, and emer-
gency medical personnel. Functional training aligns with active
occupations that can benefit from training that is specific to the
skills that transfer to the efficient movement patterns asso-
ciated with the specific job. This specialized type of training is
referred to as tactical training. The National Strength and Con-
ditioning Association (NSCA) offers educational courses and a
Tactical Strength and Conditioning Facilitator program. The
American Council on Exercise and the National Federation of
Professional Trainers both offer specialization courses and certifica-
tion specific to functional training.
WHAT THE RESEARCH REVEALS
The current body of research focusing on functional training re-
flects a vast array of exercise options with varying designs, focus,
and outcomes; however, there is very little research specific to func-
tional training as a training program. The reason stems from the
fact that functional training is a very individualized program, and
no one program can address the general population. This concept
was confirmed in the ACSM Position Stand produced in 2011 (8).
One purpose of the paper was to provide detailed evidence-based
recommendations to improve physical fitness parameters to im-
prove general health. A table was created to provide specific
recommendations and studies that represent evidence-based re-
search supporting recommendations for cardiorespiratory exercise,
TABLE 2: Synonymous and Misinterpreted Terms
Synonymous Misinterpreted
-Functional training -Sport specific
-Functional exercise -Corrective exercise
-Functional movement
-Movement science
-Performance training
-Neuromotor training
November/December 2018
resistance training, and neuromotor exercise training. There are
very specific recommendations for program development of car-
diorespiratory exercise and resistance training but very few studies
that have evaluated the benefits of neuromotor exercise training,
especially in younger adults. Therefore, the recommendations
are stated as “unknown” for volume, pattern, and progression
of neuromotor or functional training.
TRADITIONAL AND FUNCTIONAL TRAINING COMPARISON
Traditional progressive resistance training focuses on increasing
load/weight in a gradual manner with the purpose of strengthen-
ing major muscle groups often for performance and/or aesthetics.
On the other hand, functional training focuses on enhancing the
quality of movement through training specific skills associated with
movement. Figure 1 demonstrates common differences between
traditional and functional training.
ACSM refers to functional training as neuromotor training
and defines it as training that incorporates motor skills such as
balance, coordination, gait, agility, and proprioceptive training
(8). Chiung-ju et al. describe functional training in a similar
manner. They view the concept as an attempt to train muscles
in coordinated, multiplanar movement patterns and incorpo-
rate multiple joints, dynamic task, and consistent alterations
in the base of support for improved function (9). The link
between traditional and functional training is displayed within
the evidence-based principles. Three common principles are
associated with resistance training: progressive overload,
variation, and specificity (10–13). Progressive overload con-
notes a gradual increase in load placed upon the body dur-
ing training over time. Variation, also referred to as
periodization, reflects a systematic manipulation of acute
program variables over time to promote various physical
adaptations to the training. Specificity refers to designing
the program and selecting the exercises that will result in a
specific adaptation to a specific stimulus and is referred to as
the SAID principle or Specific Adaptation to Imposed Demands.
The principle most closely associated with functional training is
Figure 1. Traditional training compared with
functional training.
Volume 22 | Number 6
Copyright © 2018 American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
specificity of training (SAID principle). Nick Tumminello,
NSCA’s 2016 personal trainer of the year, explains that training
for specificity focuses on improving specific adaptations that
transfer into target movements. Training using squat variations
to improve vertical (squat) jump height is an example of a spe-
cific exercise (13). Gray describes the concept as “applied func-
tional science” (14). In clear terms, the principle of specificity
explains the need to develop a program based on the defined
outcome (15–17). Gary Gray is a respected physical therapist
and is often referred to as the “Father of Function.” Gray’s con-
cept of “applied functional science” focuses on the quality of
movement in developing a training program, a major paradigm
shift in how training and exercise are perceived (18).
“Applied Functional Science is the convergence of Physical
Sciences, Biological Sciences, and Behavioral Sciences that con-
sists of the Principles-Strategies-Techniques process for functional
assessment, training and conditioning, rehabilitation, and injury
prevention that is practical for any and all individuals regardless
of age or ability” (14).
Movement Literacy as an Art
Movement literacy implies that the health and fitness profes-
sional not only has the theoretical knowledge of the body as a bi-
ological system but also understands how biology influences
physical action and, finally, how to instruct the client, patient,
and/or athlete to achieve the desired outcome. Simply put,
training functionally requires the body and mind to work to-
gether to link efficient movement patterns resulting in the de-
fined outcome/goal. This places the burden on the health and
fitness professional to assure that link occurs and requires a spe-
cific level of rapport between the health and fitness professional
and client, patient, and/or athlete (12,14,19). Gray Cook, phys-
ical therapist and co-creator of the Functional Movement
Screen (FMS), describes this concept as movement literacy, the abil-
ity to read and write movement patterns (20). This requires the
professional to understand human movement within the body
and how to develop programs to address specific movement pat-
terns with a major focus on the importance of instruction for
efficient movement to occur. Instruction addresses the ability
of the health and fitness professional to convey the information
in a way that each patient, client, and athlete can understand
how it will benefit them on a personal level. This ability to per-
sonalize instruction is referred to as the “art” of the profession.
Nobel-prize winning physicist, Richard Feynman, explains that
the key to success as an instructor “is to be able to explain the most
complex ideas in the simplest terms” (21). For example, agility is an im-
portant secondary fitness component for all individuals and an
experienced health and fitness professional (instructor) will be
able to define how agility is important to each patient, client,
and athlete. An older client may need to enhance agility to be
able to play with their grandchildren, whereas a basketball
player needs this skill to effectively defend their opponent or
control the ball on offense.
www.acsm-healthfitness.org 39
FUNCTIONAL FITNESS: DEFINITIONS AND TRENDS
PROGRAM DESIGN CONSIDERATIONS
When a professional is presented with a concept that is broad,
confusing, and often misunderstood, it is helpful for him/her
to establish a pathway that provides a framework for defining
and describing the topic as it relates to program development.
In very general terms, functional training refers to an outcome-
based program that may include a variety of training styles that
are performed with a purpose to enhance specific movements,
related to ADLs, and/or sport-recreational skills. The common
denominator in a functional training program is simple; that is,
the outcome defines the program. So, in essence, the health and fitness
professional must first define the desired outcome and then pro-
gram to achieve it. It may sound simple, but it is not; to develop
a functional training program, one must be able to integrate
knowledge from a variety of the movement sciences such as
anatomy and functional anatomy, motor behavior, applied bio-
mechanics, exercise physiology, and human behavior. To avoid
confusion, always remember, it is critical to start with defining
the desired outcome, followed by an analysis of the movement
patterns and muscle groups that support the outcome. Specific
exercises are not “functional” in nature, but a program designed
to achieve a specific outcome can be termed a “functional”
training program.
Functional training is simple to understand on paper but
complicated to implement. To this day, there are no universally
accepted methods for how to train functionally. Health and fit-
ness professionals must use their individual experiences and cli-
ent feedback to decide the specific training method to bring
about the desired outcome for participants.
In general, fitness program development is based on the ap-
plication of PRINCIPLES that represent the scientific evidence
necessary to select the most appropriate STRATEGIES that will
lead to choosing specific TECHNIQUES or movements that
address the desired outcome (14). The principles, strategies, and
techniques should not be viewed as isolated units. Knowing how
to apply the appropriate principles, strategies, and techniques to
create a functional program for participants is the “art” of func-
tional training. Therefore, functional training is an integrated
40 ACSM’s Health & Fitness Journal ®
Copyright © 2018 American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
approach that involves becoming aware of the role the entire
body plays relative to efficient movement. Being able to move
efficiently is a central theme throughout our lives. Human
movement can be viewed on a continuum from being less func-
tional to more functional based on the ability to move efficiently.
The following progression model developed by Kennedy and
Yoke is one example that could be helpful in creating functional
movement program design insights. They developed this for fit-
ness professionals to help them organize movement progressions
in a systematic order represented by levels that could be viewed
on a continuum similar to Figure 2. See Table 3 for a descrip-
tion of each level (2,22).
Another helpful option is the FMS initially developed by
Gray Cook and Lee Burton for athletes. Visit the YouTube
video on “What is Functional Movement Screening” if you
are not familiar with the FMS testing system (https://www.
youtube.com/watch?v=p5yqSZaz4ms). The FMS is a predictive
system consisting of seven steps to rank movement patterns
basic to efficient movement and function (23). Once a general
ranking has been established, the next step is to develop an in-
dividualized program that will address the physical needs and
also the desired outcome of the patient, client, and athlete as
defined by the health and fitness professional. A functional
training program applies the most appropriate training
methods that specifically address the movements associated with
the planned outcome. This philosophy requires a backward
logic in program design as illustrated in Figure 3.
1. One must start with a defined outcome. Development of
the outcome/goal is based on critical factors such as the
following:
ο The physical and behavioral abilities of the client, pa-
tient, and athlete based on a variety of assessments.
ο The desired outcome that has been established be-
tween the health and fitness professional and the client,
patient, and athlete.
2. The health and fitness professional analyzes the screen-
ing information, the assessment results, and the desires
of the patient, client, and athlete to develop the most
appropriate training methods.
οThose training methods should promote the enhance-
ment of specific body system(s) defined in the outcome,
based on the principles and most effective strategies for
the defined outcome/goal.
ο Program implementation is based on the most appropriate
techniques or individual exercises that will ensure the patient,
client, and athlete can achieve the defined outcome/goal.
PROGRESSION RECOMMENDATIONS
Many of the general strength training programs using individual
muscle groups and exercises do not apply because functional
training programs are unique and individualized for a specific
person(s) with a purposeful goal. For example, a client is inter-
ested in purchasing a horse that will stay on the property rather
November/December 2018
Figure 2. Functional training considerations (A,B,C,D).
TABLE 3: Progression Levels
LEVEL 1: Isolate and Educate: The focus of this level is to
determine patient, client, and athlete awareness of muscle
location and function.
LEVEL 2: Add External Resistance (if applicable for the exercise
at hand): The focus of this level is to perform the exercise while
the health and fitness professional reinforces the muscle
groups involved and the proper movement patterns.
LEVEL 3: Add Functional Training Positions: The focus of this
level is to add more functional movement to the exercise. In
most progressions, the targeted muscle group is still isolated
as a primary mover while the stabilizers assist.
LEVEL 4: Combine Increased Function and Resistance: The
focus of this level is to engage more of the stabilizing muscle
groups while in functional positions.
LEVEL 5: Use Multiple Muscle Groups with Increased
Resistance and Core Challenge: The focus of this level is for
multiple muscle groups and joint actions to move simultaneously
or in combination. Resistance, balance, coordination, and
torso stability are progressive to an even higher level.
LEVEL 6: Add Balance and Increase Functional Challenge,
Speed, and Rotational Movement: This level provides the most
freedom and creativity for the health and fitness professional.
At this level, exercises may require balancing on one leg, using
a wobble board or stability ball, applying plyometric movements,
or rotating the spine while lifting or some other sport-specific
maneuver or life skill.
Selection of exercises and any modifications are based on the
assessment/screening results, the ability of the patient, client,
and athlete based on assessments, the motivation of the patient,
client, and athlete, and the defined outcome.
Volume 22 | Number 6
Copyright © 2018 American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
than a stable. This client needs to develop appropriate strength
to perform daily tasks such as move bales of hay and pick up
buckets of water. These activities require overall body strength
through movements in multiple planes. Kettlebell exercises would
be more effective than isolated exercises on machines. Progres-
sion occurs on a continuum and is a critical aspect of program
design; however, progressions are based on skills associated with
the desired movement patterns rather than any one skill as illus-
trated in Figure 2. According to ACSM, progressions for tradi-
tional resistance training are defined as “the act of moving
forward or advancing toward a specific goal over time until
the target has been achieved for the trainable characteristics of
muscular strength, power, hypertrophy, and local muscular en-
durance” (15). Figure 3 depicts a variety of progression continu-
ums that assist in understanding the thought process of applying
functional training principals to program from other profes-
sionals in the field.
SUMMARY
Functional training is a mysterious philosophy of training be-
cause of its many definitions and inconsistent implementations.
Yet, in the purest form, functional training is a dynamic concept
that is rooted in the improvement of movement and can be
adapted for any individual. The improvement of movement
can and will be interpreted differently among health and fitness
professionals. Each functional training program can be individ-
ualized with a focus on integrating movement patterns to
achieve a defined outcome/goal. At its very best, functional
training is fluid in nature and enables the professional to be cre-
ative and apply his/her knowledge, education, and experience
to help each patient, client, and athlete with whom they have
the privilege to work. So, go ahead and apply your interpretation
of functional training into your programming and see what you
come up with!
www.acsm-healthfitness.org 41
FUNCTIONAL FITNESS: DEFINITIONS AND TRENDS
Figure 3. Functional training program development.
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• Boyle M. New Functional training for Sports. Champaign (IL): Human Kinetics; 2016.
• Cook G. Movement: Functional Movement Systems. Santa Cruz (CA): On Target
Publications; 2010.
• Cook G. Athletic Body in Balance. Champaign (IL): Human Kinetics; 2003.
• Gambetta V. Athletic Development: The Art & Science of Functional Sports
Conditioning. Champaign (IL): Human Kinetics; 2007.
• Liebenson C. Functional Training Handbook. Philadelphia (PA): Lippincott Williams
& Wilkins; 2014.
• Santana JC. Functional Training. Champaign (IL): Human Kinetics; 2016.`
November/December 2018
Web sites: companies to large hospital-based programs and understands the complexities
• http://www.bodybyboyle.com/
and rewards of working in both profit and nonprofit organizations.
• https://chekinstitute.com/
• https://www.functionalmovement.com/
• https://www.ihpfitness.com/
• https://www.grayinstitute.com/
• http://www.coreperformance.com/about/
• https://www.ptonthenet.com/ BRIDGING THE GAP
• http://nicktumminello.com/
Functional training requires the body and mind to work
together to link efficient and purposeful movement
patterns resulting in a defined outcome/goal. Creating
Leslie Stenger, M.S., is an assistant professor of that link is the responsibility of the health and fitness
Exercise Science at Indiana University of Pennsylvania. professional and requires a specific level of rapport and
Leslie is an ACSM EP-C W, spinning instructor, and trust between the health and fitness professional and the
Pilates mat instructor. She has more than 25 years client, patient, and athlete. Health and fitness
of experience in the health and fitness club industry. professionals need to understand human movement,
She has worked in every segment of the industry including how to develop programs, and how to instruct individuals
corporate, community, clinical, public, and private clubs. to promote efficient and purposeful movement for the
She has gained experience from individually owned client, patient, and athlete.

Volume 22 | Number 6 www.acsm-healthfitness.org 43

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