SCOPE OF PRACTICE

The ACSM certified Personal Trainer™ is a fitness professional involved in developing and implementing an individualized approach to exercise leadership in healthy populations and/or those individuals with medical clearance to exercise. Using a variety of teaching techniques, the Personal Trainer is proficient in leading and demonstrating safe and effective methods of exercise by applying the fundamental principles of exercise science. The ACSM certified Personal Trainer™ is familiar with forms of exercise used to improve, maintain, and/or optimize health-related components of physical fitness and performance. The ACSM certified Personal Trainer™ is proficient in writing appropriate exercise recommendations, leading and demonstrating safe and effective methods of exercise, and motivating individuals to begin and to continue with their healthy behaviors.

The written exam is delivered in a computer-based testing format (in English), at a Pearson VUE authorized testing center worldwide. The exam contains approximately 125-150 multiple choice questions based on KSAs (knowledge, skills and abilities) distributed across the following content areas. The table below lists the approximate percentage of questions from each content area, based the below KSAs:
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EXERCISE PHYSIOLOGY AND RELATED EXERCISE SCIENCE

 • Knowledge of the basic structures of bone, skeletal muscle and connective tissues.

• Knowledge of the basic anatomy of the cardiovascular system and respiratory system.

• Knowledge of the definition of the following terms: inferior, superior, medial, lateral, supination, pronation, flexion, extension, adduction, abduction, hyperextension, rotation, circumduction, agonist, antagonist and stabilizer.

• Knowledge of the plane in which each muscle action occurs.

• Knowledge of the interrelationships among center of gravity, base of support, balance, stability and proper spinal alignment.

• Knowledge of the following curvatures of the spine: lordosis, scoliosis and kyphosis.

• Knowledge to describe the myotatic stretch reflex.

• Knowledge of the biomechanical principles for the performance of the following activities: walking, jogging, running, swimming, cycling, weight lifting and carrying moving objects.

• Ability to define aerobic and anaerobic metabolism.

• Knowledge to describe the normal acute responses to cardiovascular exercise.

• Knowledge to describe the normal acute responses to resistance training.

• Knowledge of the normal chronic physiological adaptations associated with cardiovascular exercise.

• Knowledge of the normal chronic physiological adaptations associated with resistance training.

• Knowledge of the physiological principles related to warm-up and cool-down.

• Knowledge of the common theories of muscle fatigue and delayed onset muscle soreness (DOMS).

• Knowledge of the physiological adaptations that occur at rest and during submaximal and maximal exercise following chronic aerobic and anaerobic exercise training.

• Knowledge of the physiological principles involved in promoting gains in muscular strength and endurance.

• Knowledge of blood pressure responses associated with acute exercise, including changes in body position.

• Knowledge of how the principle of specificity relates to the components of fitness.

• Knowledge of the concept of detraining or reversibility of conditioning and its implications in fitness programs.

• Knowledge of the physical and psychological signs of overtraining and to provide recommendations for these problems.

• Knowledge of the following terms: progressive resistance, isotonic/isometric, concentric, eccentric, atrophy, hypertrophy, sets, repetitions, plyometrics, Valsalva maneuver.

• Ability to identify the major bones and muscles. Major muscles include, but are not limited to the following: trapezius, pectoralis major, latissimus dorsi, biceps, triceps, rectus abdominis, internal and external obliques, erector spinae, gluteus maximus, quadriceps, hamstrings, adductors, abductors and gastrocnemius.

• Ability to identify the major bones. Major bones include, but are not limited to the clavicle, scapula, sternum, humerus, carpals, ulna, radius, femur, fibia, tibia and tarsals.

• Ability to identify the joints of the body.

• Knowledge of the primary action and joint range of motion for each major muscle group.

• Ability to locate the anatomic landmarks for palpation of peripheral pulses.
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HEALTH APPRAISAL AND FITNESS EXERCISE TESTING

• Knowledge of and ability to discuss the physiological basis of the major components of physical fitness: flexibility, cardiovascular fitness, muscular strength, muscular endurance and body composition.

• Knowledge of the importance of a health/medical history.

• Knowledge of the value of a medical clearance prior to exercise participation.

• Knowledge of the categories of participants who should receive medical clearance prior to administration of an exercise test or participation in an exercise program.

• Knowledge of relative and absolute contraindications to exercise testing or participation.

• Knowledge of the limitations of informed consent and medical clearance prior to exercise testing.

• Knowledge of the advantages/disadvantages and limitations of the various body composition techniques including, but not limited to: air displacement, plethysmography, hydrostatic weighing, Bod Pod, bioelectrical impedance.

• Skill in accurately measuring heart rate and obtaining rating of perceived exertion (RPE) at rest and during exercise according to established guidelines.

• Ability to locate common sites for measurement of skin fold thickness and circumferences (for determination of body composition and waist-hip ratio).

• Ability to obtain a basic health history risk appraisal and to stratify risk in accordance with ACSM Guidelines.

• Ability to explain and obtain informed consent.

• Ability to instruct participants in the use of equipment and test procedures.

• Knowledge of the purpose and implementation of pre-activity fitness testing, including assessments of cardiovascular fitness, muscular strength, muscular endurance and flexibility, and body composition.

• Ability to identify appropriate criteria for terminating a fitness evaluation and demonstrate proper procedures to be followed after discontinuing such a test.
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EXERCISE PRESCRIPTION (TRAINING) AND PROGRAMMING

• Knowledge of the benefits and risks associated with exercise training in prepubescent and post pubescent youth.

• Knowledge of the benefits and precautions associated with resistance and endurance training in older adults.

• Knowledge of specific leadership techniques appropriate for working with participants of all ages.

• Knowledge of how to modify cardiovascular and resistance exercises based on age and physical condition.

• Knowledge of and ability to describe the unique adaptations to exercise training with regard to strength, functional capacity, and motor skills.

• Knowledge of common orthopedic and cardiovascular considerations for older participants and the ability to describe modifications in exercise prescription that is indicated.

• Knowledge of selecting appropriate testing and training modalities according to the age and functional capacity of the individual.

• Knowledge of the recommended intensity, duration, frequency and type of physical activity necessary for development of cardio respiratory fitness in an apparently healthy population.

• Knowledge to describe, and the ability to demonstrate (such as technique and breathing), exercises designed to enhance muscular strength and/or endurance of specific major muscle groups.

• Knowledge of the principles of overload, specificity, and progression and how they relate to exercise programming.

• Knowledge of the components incorporated into an exercise session and the proper sequence (i.e., pre-exercise evaluation, warm-up, aerobic stimulus phase, cool-down, muscular strength and/or endurance and flexibility).

• Knowledge of special precautions and modifications of exercise programming for participation at altitude, different ambient temperatures, humidity, and environmental pollution.

• Knowledge of the importance and ability to record exercise sessions and performing periodic evaluations to assess changes in fitness status.

• Knowledge of the advantages and disadvantages of implementation of interval, continuous and circuit training programs.

• Knowledge of the concept of “Activities of Daily Living” (ADLs) and its importance in the overall health of the individual.

• Knowledge of Progressive Adaptation in resistance training and its implications on program design and periodization.

• Understanding of personal training client’s “personal space” and how it plays into a trainer’s interaction with their client.

• Skill to teach and demonstrate the components of an exercise session (i.e., warm-up, aerobic stimulus phase, cool-down, muscular strength/endurance, flexibility).

• Skill to teach and demonstrate appropriate modifications in specific exercises for the following groups: older adults, pregnant and postnatal women, obese persons, and persons with low back pain.

• Skill to teach and demonstrate appropriate exercises for improving range of motion of all major joints.

• Skill in the use of various methods for establishing and monitoring levels of exercise intensity, including heart rate, RPE and METs.

• Knowledge of and ability to apply methods used to monitor exercise intensity, including heart rate and rating of perceived exertion.

• Ability to describe modifications in exercise prescriptions for individuals with functional disabilities and musculoskeletal injuries.

• Ability to differentiate between the amount of physical activity required for health benefits and the amount of exercise required for fitness development.

• Ability to determine training heart rates using two methods: percent of age-predicted maximum heart rate and heart rate reserve (Karvonen).

• Ability o identify proper and improper technique in the use of resistive equipment such as stability balls, weights, bands, resistance bars, and water exercise equipment.

• Ability to identify proper and improper technique in the use of cardiovascular conditioning equipment (e.g., stair climbers, stationary cycles, treadmills, elliptical trainers).

• Ability to teach a progression of exercises for all major muscle groups to improve muscular strength and endurance.

• Ability to modify exercises based on age and physical condition.

• Ability to explain and implement exercise prescription guidelines for apparently healthy clients or those who have medical clearance to exercise.

• Ability to adapt frequency, intensity, duration, mode, progression, level of supervision, and monitoring techniques in exercise programs for apparently healthy clients or those who have medical clearance to exercise.

• Ability to design resistive exercise programs to increaser or maintain muscular strength and /or endurance.

• Ability to periodize resistance training program for continued muscular strength development.

• Ability to evaluate, prescribe and demonstrate appropriate flexibility exercises for all major muscle groups.

• Ability to design training programs using interval, continuous, and circuit training programs.

• Knowledge of the role of carbohydrates, fats and proteins as fuels for aerobic and anaerobic metabolism.

• Knowledge to define the following terms: obesity, overweight, percent fat, Body Mass Index, lean body mass, anorexia nervosa, bulimia nervosa, and body fat distribution.

• Knowledge of the relationship between body composition and health.

• Knowledge of the effects of diet plus exercise, diet alone, and exercise alone as methods for modifying body composition.

• Knowledge of the importance of an adequate daily energy intake for healthy weight management.

• Knowledge of the importance of maintaining normal hydration before, during and after exercise.

• Knowledge of the USDA Food Pyramid.

• Knowledge of the female athlete triad.

• Knowledge of the myths and consequences associated with inappropriate weight loss methods (e.g., saunas, vibrating belts, body wraps, electric simulators, sweat suits, fad diets).

• Knowledge of the number of kilocalories in one gram of carbohydrate, fat, protein and alcohol.

• Knowledge of the number of kilocalories equivalent to loosing 1 pound of body fat.

• Knowledge of the guidelines for caloric intake for an individual desiring to loose or gain weight.

• Knowledge of common nutritional ergogenic aids, the purported mechanism of action and any risk and/or benefits (e.g., carbohydrates, protein/amino acids, vitamins, minerals, sodium bicarbonate, creatine, bee pollen, etc.).

• Ability to describe the health implications of variation in body fat distribution patterns and the significance of the waist to hip ratio.
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HUMAN BEHAVIOR

• Knowledge of at least five behavioral strategies to enhance exercise and health behavior change (e.g., reinforcement, goal setting, social support).

• Knowledge of the sages of motivational readiness.

• Knowledge of the 3 stages of learning: Cognitive, Associative, Autonomous.

• Knowledge of specific techniques to enhance motivation (e.g., posters, recognition, bulletin boards, games, competitions). Define extrinsic and intrinsic reinforcement and give examples of each.

• Knowledge of the different types of learners (auditory, Visual, Kinesthetic) and how to apply teaching and training techniques to optimize a client’s training session.

• Knowledge of the types of feedback and ability to use communication skills to optimize a client’s training session.
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SAFETY, INJURY PREVENTION AND EMERGENCY PROCEDURES

• Knowledge of and skill in obtaining basic life support and cardiopulmonary resuscitation certification.

• Knowledge of appropriate emergency procedures (i.e., telephone procedures, written emergency procedures, personnel responsibilities) in a health and fitness setting.

• Knowledge of basic first aid procedures for exercise-related injuries, such as bleeding, strains/sprains, fractures, and exercise intolerance (dizziness, syncope, heat injury).

• Knowledge of basic precautions taken in an exercise setting to ensure participant safety.

• Knowledge of the physical and physiological signs and symptoms of overtraining.

• Knowledge of the effects of temperature, humidity, altitude and pollution on the physiological response to exercise.

• Knowledge of the following terms: shin splints, sprain, strain, tennis elbow, bursitis, stress fracture, tendonitis, patello-femoral pain syndrome, low back pain, plantar fasciitis, and rotator cuff tendonitis.

• Knowledge of hypothetical concerns and potential risks that may be associated with the use of exercises such as straight leg sit-ups, double leg raises, full squats, hurdlers stretch, yoga plough, forceful back hyperextension, and standing bent-over to touch.

• Knowledge of safety plans, emergency procedures, and first aid techniques needed during fitness evaluations, exercise testing, and exercise training.

• Knowledge of the cPT’s responsibilities, limitations, and the legal implications on carrying out emergency procedures.

• Knowledge of potential musculoskeletal injuries (e.g., contusions, sprains, strains, fractures), cardiovascular/pulmonary complications (e.g., tachycardia, bradycardia, hypotension/hypertension, tachypnea) and metabolic abnormalities (e.g., fainting/syncope, hypoglycemia/hyperglycemia, hypothermia/hyperthermia).

• Knowledge of the initial management and first aid techniques associated with open wounds, musculoskeletal injuries, cardiovascular/pulmonary complications, and metabolic disorders.

• Knowledge of the components of an equipment maintenance/repair program and how it may be used to evaluate the condition of exercise equipment to reduce the potential risk of injury.

• Knowledge of the legal implications of documented safety procedures, the use of incident documents and ongoing safety training.

• Skill in demonstrating appropriate emergency procedures during exercise testing and/or training.

• Ability to identify the components that contribute to the maintenance of a safe environment.

• Ability to assist or “spot” a client in a safe and effective manner during resistance exercise.
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PROGRAM ADMINISTRATION, QUALITY ASSURANCE AND OUTCOME ASSESSMENT

• Knowledge of the cPT’s role in administration and program management within a health/fitness facility.

• Knowledge of and the ability to use the documentation required when a client shows abnormal signs or symptoms during an exercise session and should be referred to a physician.

• Knowledge of professional liability and most common types of negligence seen in training environments.

• Understand the practical and legal ramifications of the employee vs. independent contractor classifications as they relate to personal trainers.

• Knowledge of appropriate professional conduct, practice standards, and ethics in relationships dealing with clients, employers, and other allied health/medical/fitness professionals.

• Knowledge of the types of exercise programs available in the community and how these programs are appropriate for various populations.

CLINICAL AND MEDICAL CONSIDERATIONS

• Knowledge of cardiovascular, respiratory, metabolic and musculoskeletal risk factors that may require further evaluation by medical or allied health professionals before participation in physical activity.

• Knowledge of risk factors that may be favorably modified by physical activity habits.

• Knowledge of the risk factor concept of Coronary Artery Disease (CAD) and the influence of heredity and lifestyle on the development of CAD.

• Knowledge of how lifestyle factors, including nutrition, physical activity, and heredity, influence blood lipid and lipoprotein (i.e., cholesterol: high-density lipoprotein and low-density lipoprotein) profiles.

• Knowledge of cardiovascular risk factors or conditions that may require consultation with medical personnel before testing and training, including inappropriate changes of resting or exercise heart rate and blood pressure, new onset discomfort in chest, neck, shoulder, or arm, changes in the pattern of discomfort during rest or exercise, fainting or dizzy spells, and claudication.

• Knowledge of respiratory risk factors or conditions that may require consultation with medical personnel before testing or training, including asthma, exercise-induced bronchospasm, extreme breathlessness at rest or during exercise, bronchitis and emphysema.

• Knowledge of metabolic risk factors or conditions that may require consultation with medical personnel before testing or training, including body weight more than 20% above optimal, BMI>30, thyroid disease, diabetes or glucose intolerance and hypoglycemia.

• Knowledge of musculoskeletal risk factors or conditions that may require consultation with medical personnel before testing or training, including acute or chronic back pain. Osteoarthritis, rheumatoid arthritis, osteoporosis, tendonitis, and low back pain.

• Knowledge of the basic principles of electrical conduction of the heart, its phases of contraction, and its implications.

• Knowledge of common drugs from each of the following classes of medications and describe their effects on exercise: antianginals; antihypertensives, antiarrhythmics; bronchodilators; hypoglycemics; psychotropics; and vasodilators.

• Knowledge of the effects of the following substances on exercise: antihistamines, tranquilizers, alcohol, diet pills, cold tablets, caffeine, and nicotine.
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