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 referred clients presenting with chronic conditions.

1.1. Receive exercise referral from a 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 this pathology.

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 chronic condition  and co-morbidities and record information according to relevant legislation  and organisational policies and procedures .

1.6. Explain the physiology of chronic conditions and associated risk factors  to the client in simple terms and confirm client understanding.

1.7. Explain to the client the causes and consequences of specific chronic conditions in the context of their effect on exercise capacity and conditions.

1.8. Explain to the client the role of physical activity and exercise in managing chronic conditions and enhancing health.

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

1.10. Explain to the client and their family members where necessary their need to be referred back to a medical or allied health professional if their condition becomes unstable.

1.11. Establish client needs  and identify any potential barriers to exercise, and discuss methods to enhance exercise adherence with the client.

1.12. Clarify any areas of concern with the referring medical or allied health professional , in conjunction with the client.

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

2. Deliver prescribed exercise programs.

2.1. Undertake appropriate fitness assessments as required.

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

2.3. 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.

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

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

2.6. Demonstrate how modifications  to the exercise can incorporate the different needs of older clients 

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

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

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

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

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

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

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

3.6. Monitor progress and report outcomes to the client.

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

4. Provide advice regarding additional lifestyle modifications  to enhance the management of the condition.

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

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

4.3. 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 provide clear instruction and constructive feedback to older clients, family members, medical or allied health professionals
• problem-solving skills to:

• identify exercises targeted at specific fitness components or medical conditions and make modifications where required
• recognise conditions outside own scope of practice and make appropriate recommendations and referrals

• team work skills to work collaboratively with medical or allied health professionals according to legal and ethical conditions
• 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
• planning and organising skills to plan and instruct the exercise session including accessing all required equipment and making appropriate modifications to equipment
• interpersonal skills to interact effectively with older adults.
• observation skills to monitor the performance of older clients and recognise where and when modifications are required.
• literacy skills to accurately document and report on client progress
• numeracy skills to manage the time of classes and facility schedules.

Required knowledge 

• the medical and allied health sector to enable appropriate recommendations to be made to older clients and family members
• principles of biomechanics and exercise science to enable the selection of exercises appropriate to participant conditions and needs
• physiological, social and emotional processes of ageing to enable effective planning of programs.
• age related health conditions to enable appropriate selection and modification of exercises.
• principles of exercise program design to enable development of a program for a specific condition or multiple conditions.
• relevant legislation and organisational policies and procedures to enable safe and appropriate conduct of exercise for older clients.

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 accredited exercise physiologist or relevant medical or allied health professional 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 older clients with chronic conditions 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 older clients
• develops a variety of sessions for physical activity classes for a range of client groups of older clients with chronic conditions
• modifies individual exercises to accommodate the specific needs of the client
• evaluates exercise sessions and modifies exercise plans according to feedback received from clients and own evaluation.

Context of and specific resources for assessment 

Assessment must ensure training of multiple exercise sessions that are of sufficient duration and breadth to allow the demonstration of competency and consistency of performance

Assessment must also ensure access to:

• a facility or venue where a variety of exercise modes and equipment are available, such as a weights gym, pool, exercise room and open air
• a range of real or simulated medical or allied health professional referrals for a range of older clients with chronic conditions
• relevant documentation such as client record forms
• a range of participant groups composed of older adults with a variety of chronic conditions.

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 instructing and monitoring exercise classes for older clients with unstable conditions
• oral or written questioning to assess knowledge of ageing process, specific medical conditions and how these relate to effective exercise planning
• portfolio of plans for physical activity programs for older clients with different unstable conditions
• third-party reports from a supervisor detailing work performance.

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
• psychologist
• aboriginal health worker
• diabetes educator.

Chronic conditions  may include:

• asthma
• autoimmune diseases
• cancer
• cardiovascular diseases
• chronic fatigue
• chronic obstructive pulmonary disease
• diabetes
• hepatitis
• osteoarthritis
• osteoporisis
• renal failure
• rheumatoid arthritis.

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.

Risk factors  may include:

• family history
• obesity
• joint trauma and injury
• menopause in females
• repetitive occupational use
• physical inactivity
• eating disorders
• low body weight and calcium intake
• smoking.

Client needs  may include:

• consideration of adaptations of older clients
• methods of instruction
• time delivery to achieve outcomes
• changes to environment and or spaces
• adaptation and modification of equipment.

Cardiorespiratory conditioning  may include:

• Choice of exercises and location:

• appropriate to condition and health needs
• emphasis on functional capacity and activities of daily living such as mobility
• gait, coordination, balance limitations
• low initial fitness level, easily fatigued
• inefficient movement
• possible cognitive impairment

• integration with muscular training:

• prior improvement in strength, balance and range of motion
• use of exercise machines and circuit training

• low fitness level and need for gradual progression.

Muscular conditioning  may include:

• muscular endurance
• muscular strength
• muscular power.

Instructional techniques  may include:

• transitions between exercises or games
• class structure variations
• communication skills
• verbal and visual instructions relevant to client conditions
• technique correction.

Exercise programs  may include:

• cardiovascular
• strength training
• flexibility
• agility
• balance
• posture and core stability
• fundamental movement skills
• aquatic exercise.

Modifications  may include:

• accommodations for the physical changes and unstable health conditions
• accommodations for the social and psychological changes that occur with ageing

Older clients  may include:

• adults 50 years and over with:

• one chronic condition

• multiple conditions

Exercise equipment  may include:

• treadmill
• cycle
• ergometers
• rowing machine
• dumbbells and strength training equipment
• small equipment
• chairs
• balance equipment
• interactive equipment
• circuit-based equipment
• aquatic.

Symptoms requiring interjection  may include:

• shortness of breath at rest or with mild exertion
• dizziness or syncope
• orthopnea or paroxysmal nocturnal dyspnea
• palpitations or tachycardia
• intermittent claudication
• unusual fatigue or shortness of breath with usual activities
• illness or sickness
• lack of functional strength
• neck soreness 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.

Unstable condition  may include:

• musculoskeletal
• sensory impairment
• dementia
• metabolic conditions
• physical disabilities
• neurological disorders
• joint replacement
• claudication
• angina
• stroke
• COPD and or COAD.

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.