Unit of competency details

ELEMENT 

PERFORMANCE CRITERIA 

Elements describe the essential outcomes of a unit of competency.

Performance criteria describe the performance needed to demonstrate achievement of the element. Where bold italicised text is used, further information is detailed in the required skills and knowledge section and the range statement. Assessment of performance is to be consistent with the evidence guide.

1. Consult with clients presenting with neurological impairment.

1.1. Receive exercise referral from a relevant medical or allied health professional .

1.2. Confirm exercise referral has sufficient detail to allow flexibility for modifications to accommodate progression of the client.

1.3. Become familiar with typical adverse signs and symptoms that may arise during exercise for clients with neurological impairment or disability .

1.4. Consult with an appropriate medical or allied health professional  as necessary.

1.5. Discuss with the client their complete exercise history and their neurological impairment and record relevant information according to relevant legislation  and organisational policies and procedures .

1.6. Explain to the client the different roles of cardiovascular and muscular conditioning , and the reasons for their inclusion in the exercise prescription.

1.7. Confirm the outcomes of a goals and needs analysis  in collaboration with the client and the medical or allied health professional  if appropriate.

1.8. Explain to the client their need to be referred back to a medical or allied health professional if their condition becomes unstable.

1.9. Identify any potential barriers to exercise and discuss methods to enhance exercise adherence  with the client.

1.10.Clarify any areas of concern with the referring accredited exercise physiologist or relevant medical or allied health professional , in conjunction with the client.

1.11.Obtain the informed consent of the client and maintain the client's records  according to relevant legislation  and organisational policies and procedures .

2. Consult with clients presenting with disabilities.

2.1. Receive exercise referral from medical and allied health professional if applicable or undertake pre-exercise screening with client.

2.2. Interpret referral and pre -exercise screening  and seek clarification from medical or allied health professional.

2.3. Discuss with the client their complete exercise history and condition and record relevant information according to relevant legislation and organisational policies and procedures.

2.4. Explain to the client the role and benefits of physical activity in managing disabilities  and enhancing health.

3. Deliver prescribed exercise programs.

3.1. Undertake appropriate fitness assessment  as required.

3.2. Work with medical or allied health professional  to deliver an exercise plan in accordance with recognised exercise recommendations, fitness test results, client limitations, and potential interactions of medications.

3.3. Explain to the client the different roles of cardiorespiratory and muscular conditioning , and the reasons for their inclusion as part of the client's exercise prescription.

3.4. Explain to the client the exercise variables to be implemented in the context of managing their specific cardiorespiratory conditions.

3.5. Apply instructional techniques  to ensure safe and appropriate application of the exercise program  by the client.

3.6. Demonstrate the safe and appropriate use of selected exercise equipment  and report or address any unsafe equipment according to organisational policies and procedures.

4. Monitor and review clients responses to the prescribed exercise program.

4.1. Monitor perceived exercise intensity and make adjustment as required.

4.2. Assess the client's performance and explain and correct any unsafe exercise procedures.

4.3. Monitor client responses  for any typical signs and symptoms requiring intervention  that may occur during exercise.

4.4. Apply procedures to respond to signs and symptoms requiring intervention  as required according to relevant legislation and organisational policies and procedures.

4.5. Recognise signs of an unstable condition  and refer the client back to an appropriate medical or allied health professional .

4.6. Monitor progress and report outcomes to the client.

4.7. Revise the client's record and advise the referral source of suggested changes to the exercise program if required.

5. Provide advice regarding additional lifestyle modifications  to enhance the management of the disability or neurological impairment.

5.1. Obtain information about the client's current lifestyle.

5.2. Discuss possible barriers to behaviour change and implementation of healthy eating practices.

5.3. Provide information about the fundamental features of balanced nutrition and recommend modifications to dietary intake to improve general health and reduce the risk of cardiovascular disease.

5.4. Recommend other lifestyles changes to improve current disease status.

This section describes the skills and knowledge required for this unit.

Required skills 

• communication skills to:

• elicit and convey information to clients with neurological conditions or disabilities
• develop rapport with clients
• clarify potential risks and concerns with treating medical or allied health professionals

• Problem-solving skills to identify adverse signs and symptoms requiring intervention and unsafe exercise performance and to recommend appropriate changes in consultation with an appropriate medical or allied health professional
• teamwork skills to work collaboratively with medical and allied health professionals according to all legal and ethical considerations
• decision making skills to determine suitable exercise selection and progression
• analytical skills to interpret information on the health and functional status of clients with disabilities or neurological impairments in terms of their medical conditions, risk factors, medical treatments and exercise history
• literacy and numeracy skills to enable the accurate interpretation of referrals and to record client exercise programs and calculate and adjust exercise duration and frequency.
• decision making skills to determine appropriate instructional techniques.
• literacy skills to accurately document and report on client progress.

Required knowledge 

• physical and cognitive consequences of common neurological impairments likely to be encountered in the exercise setting including:

• cerebral palsy
• multiple sclerosis
• Parkinson's disease
• spinal cord injury
• acquired brain injury
• stroke
• dementia
• muscular dystrophy
• autism spectrum disorder

• effect of neurological conditions on the acute response to exercise to enable assessment of the individual's functional capacity when developing exercises
• anatomy and physiology of the musculoskeletal system and its supporting systems to enable appropriate design of exercise programs
• nervous system and its relationship to movement
• digestive system and its relationship to exercise performance
• physiology of specific disabilities and associated risk factors in relation to exercise to enable safe and effective exercise outcomes
• causes and consequences of specific disabilities in the context of their effect on exercise capacity and the role of physical activity in managing disability and enhancing health
• directional and movement terminology to enable effective communication with medical and allied health professionals
• range of motion and stretching techniques to enable the inclusion of exercise variables to suit client's functional capacity
• the role of physical activity in improving functionality in clients with neurological conditions
• relevant legislation and organisational policies and procedures to maintain the safety of clients and the confidentiality of client information
• use, care and maintenance of facility equipment to maintain safety of clients and other facility users.

The evidence guide provides advice on assessment and must be read in conjunction with the performance criteria, required skills and knowledge, range statement and the Assessment Guidelines for the Training Package.

Overview of assessment 

Critical aspects for assessment and evidence required to demonstrate competency in this unit 

Evidence of the following is essential:

• communicates effectively with medical or allied health professionals regarding relevant health and functional status of the referred client
• effective communication skills to discuss aspects of exercise prescription with clients
• when appropriate, react to adverse events to deal with exercise program problems and issues
• ability to correctly interpret the exercise prescription and make modifications consistent with prescribed parameters and scope of practice
• safely and effectively delivers exercise for referred clients with disabilities and neurological impairment and recommends appropriate alterations according to client's physical and motivational responses
• monitors and maintains the safety of clients, exercise equipment and the exercise setting and applies effective contingency management techniques to deal with problems and issues that may arise during the exercise program
• applies all relevant legal and ethical requirements when discussing and recording client information
• demonstrates appropriate manner, empathy and patience when working with clients with disabilities and neurological impairment

Context of and specific resources for assessment 

Assessment must ensure demonstration of skills over a period of time within a facility where a variety of exercise modes and equipment are available to support effective exercise for clients with disabilities and neurological impairment.

Assessment must also ensure access to:

• a facility where a variety of exercise modes and equipment are available, such as exercise machines, weight machines, exercise mats and adequate floor space
• a range of clients with real or simulated neurological impairment from a range of ages
• a range of clients with real or simulated disability from a range of ages
• a range of real or simulated medical and allied health professional referrals for a range of clients with neurological impairment
• demonstration of skills on sufficient occasions to determine competence in interpreting relevant information and delivering the prescribed exercise program for a range of clients with disabilities and neurological impairment.
• relevant documentation such as client record forms.

Method of assessment 

A range of assessment methods should be used to assess practical skills and knowledge. The following examples are appropriate for this unit:

• observation of consulting with clients and adjusting standard exercise prescriptions to account for a range of neurological impairments, disabilities and risk factors to focus on functional capacity and health rather than physical fitness
• observation of dealing effectively with a range of contingencies such as real or simulated client injuries or inability to complete the exercise prescription
• oral and or written questioning to assess knowledge of physical and cognitive consequences of common neurological impairments and disabilities likely to be encountered in the exercise setting
• third-party reports from a supervisor detailing work performance.

Holistic assessment with other units relevant to the industry sector, workplace and job role is recommended.

The range statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Bold italicised wording, if used in the performance criteria, is detailed below. Essential operating conditions that may be present with training and assessment (depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts) may also be included.

Medical or allied health professional  may include:

• sports physician
• sports doctor
• general practitioner
• physiotherapist
• accredited exercise physiologist
• occupational therapist
• remedial massage therapist
• chiropractor
• osteopath
• accredited practising dietician
• podiatrist
• psychologist
• aboriginal health worker.

Client  may include:

• older
• sedentary
• overweight or obese.

Neurological impairment  may include:

• cerebral palsy
• acquired brain injury
• stroke
• Parkinson's disease
• multiple sclerosis
• spinal cord injury
• dementia
• autism spectrum disorder
• muscular dystrophy
• spasticity.

Disability  may include:

• intellectual
• physical
• neurological
• sensory.

Relevant legislation  may include:

• Occupational Health and Safety
• duty of care
• privacy
• codes of practice
• fair trading.

Organisational policies and procedures  may include:

• Occupational Health and Safety
• emergency procedures
• risk management
• use of client record systems
• collection and use of client information
• equipment use and maintenance
• client supervision
• incident reporting
• client screening procedures
• client referral procedures.

Muscular conditioning  may include:

• muscular strength
• muscular power
• muscular endurance

Goals and needs analysis  may include:

• timeframes
• appropriate exercise program adjustments
• barriers
• motivation.

Barriers  may include:

• physical access
• client attitude
• perceived limitations.

Methods to enhance exercise adherence  may include:

• rewards for attendance and participation
• statement of intent
• perceived choice
• goal setting.

Records  may include:

• electronic
• hand written.

Pre -exercise screening  may include:

• medical clearance
• current client condition
• medical and exercise history
• functional limitations
• medication
• fitness goals
• time availability.

Disabilities  may include:

• paraplegic
• quadriplegic
• visually impaired
• hearing impaired
• cerebral palsy
• chromosomalabnormalities:

• down syndrome
• turner syndrome

• chronic pain
• brain injury
• amputee
• intellectual disabilities
• stroke
• muscular dystrophy
• joint replacement.

Fitness assessment  may include:

• neurological or relevant disability response to exercise
• range of movement
• strength
• girth measurements
• posture.

Instructional techniques  may include:

• demonstration
• explanation
• positive feedback
• motivational strategies.

Exercise program  may include:

• exercise selection
• exercise sequence
• exercise variety.

Exercise equipment  may include:

• free weight equipment
• resistance training machines
• hydraulic machines
• aquatic equipment
• resistance bands.

Monitor client responses  may include:

• rating of perceived exertion (RPE)
• heart rate measures
• 'talk test'
• direct observation.

Symptoms requiring intervention  may include:

• shortness of breath at rest or with mild exertion
• dizziness or syncope
• unusual fatigue
• illness or sickness
• weakness
• neck pain or strain
• pain on movement of any body part.

Procedures to respond to signs and symptoms requiring intervention may include :

• cessation of activity
• first aid
• emergency medical assistance
• referral.

Signs of an unstable condition  may include:

• fatigue and weakness
• cardiac pain
• breathlessness
• oedema
• palpitations
• claudication pain
• dizziness.

Lifestyle modifications  may include:

• moderation of alcohol consumption
• cessation of smoking
• increased incidental activity
• stress reduction
• provision of health eating guidelines
• provision of healthier choices.

Alterations to the exercise variables  may include:

• duration
• frequency
• intensity.

Pre -exercise screening  may include:

• initial screening may consist of:

• questionnaire
• interview
• medicalclearance

• initial screening should determine whether the client:

• has a medical condition
• has an injury
• is on prescribed medication

• forms used:

• pre-activity screening questionnaire
• informed consent
• medical clearance

• information obtained:

• medical history
• functional limitations
• medication
• lifestyle evaluation
• fitness goals
• exercise history
• time availability.