Elements and Performance Criteria

The Range Statements provide advice to interpret the scope and context of this unit of competence, allowing for differences between enterprises and workplaces. The Range Statements relate to the unit as a whole and helps facilitate holistic assessment. In addition, the following variables may be present for this particular unit of competency:

Allied health and medical professional

the following allied health professionals may be suitably credentialled

Physiotherapists

Chiropractors

Exercise Physiologist

Occupational Therapists

Osteopaths

Massage Therapists

Sports Physicians

Medical Practitioners

Podiatrists

Dieticians

Therapeutic recreation (Diversional Therapist)

Cardio-respiratory conditioning

choice of exercises and location

appropriate to impairment and health needs

within context of exercise prescription

emphasis on functional capacity and activities of daily living, eg, mobility

gait, coordination, balance limitations

low initial fitness level, easily fatigued

inefficient movement

possible cognitive impairments

integration with muscular training

may first need to improve strength, balance and range of motion

use of exercise machines and circuit training

low initial fitness level and need for gradual progression

Cardio-respiratory considerations
cardiovascular disease
hypertension
stroke
peripheral vascular disease
coronary heart disease
chronic heart failure
angina pectoris
arteriosclerosis
embolism
thrombosis
respiratory disease
asthma
bronchitis
pneumonia
pleurisy
obstructive sleep apnoea
chronic obstructive pulmonary disease
deep vein thrombosis
emphysema
lung cancer

Communication strategies

listening skills

empathy

body language

negotiation skills

Components of an exercise session

importance of warm-up and cool-down in context of client's health needs

incorporation of stretching

role of different conditions methods in health context

muscular conditioning

cardio-respiratory conditioning

balance of different methods

health justification of each components

time efficiency

Exercise adherence

rewards for attendance and participation

statement of intent

perceived choice

goal setting

Exercise program

exercise selection

sequence of exercises

enjoyable

variety

general training principles

matches clients goals and needs

logical progression

Exercise leadership and design of exercise sessions for clients with cardio-respiratory considerations

individual and group instruction

clear instructions and demonstrations

respect for client as individual

explaining relevant occupational health and safety issues in accordance to organisational policies and procedures and the individual client

encourage client to seek clarification on any information needed

ensure the client is working at an appropriate intensity

formal and informal instruction and supervision

importance of warm-up and cool-down

adaptation of exercise setting, equipment and program

role of different outcomes of physical conditioning

fitness needs

health needs

functional capacity needs

integration of various modes appropriate to needs and impairment, eg, importance of stretching

give positive feedback and encouragement

Exercise variables

duration

frequency

intensity

optimum combination for different types and severity of impairment and desired outcomes

Instructional techniques

establishing a rapport

level of instruction compares with level of client knowledge

empathy

creating a safe environment

instructional position

body language

eye contact

clarity of instruction

verbal communication

encouragement

voice clarity

non verbal communication

mannerisms

personality

demonstration strategies

motivational strategies

avoidance against competing with the client

positives and negatives of different instructional techniques

positive feedback

flexibility in instructional technique

Medications
blockers
calcium channel blockers
diuretics
angiotensin converting enzyme inhibitors (ace inhibitors)
vasodilators
bronchodilators
lipid lowering drugs

Methods to enhance knowledge

research

medical journals

internet

books

mentoring

seminars

conferences

Muscular conditioning
choice of apparatus and exercises
weight machines, dumbbells, elastic bands
appropriate to cardio-respiratory consideration
within context of exercise prescription
whole body, isolated muscles
posture, gait, coordination, balance
muscle tone, spasticity and stretching
emphasis on functional capacity and activities of daily living, eg, wheelchair transfer
safe and effective exercises
range of motion and limitation for certain movements
posture and body position control
spotting, strapping, direct supervision and assistance
moderate intensity, gradual progression
monitor for adverse reactions
integration with cardio-respiratory training

Pre-exercise screening

initial screening may consist of

questionnaire

interview

medical clearance

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

Professional behaviour in relationship and communication with clients and allied health professionals

confidentiality of client health and personal information

when to refer client who shows untoward response or requires alteration of exercise prescription

correspondence and communication with allied health professionals about clients with cardio-respiratory considerations

Review and modify the exercise program

review clients needs and goals

assess program outcomes

positive and constructive feedback

review client's condition

modify program

sets

reps

exercises

intensity

time

Risk factors

family history, eg, myocardial infarction, coronary revascularization, sudden death before 55 years of age in father or other male first-degree relative or before 65 years of age in mother or other female first degree relative

cigarette smoker

hypertension, ie, systolic blood pressure of >=140 mm hg or diastolic >=90 mm hg confirmed by measurement on at least two separate occasions, or taking any antihypertensive medication

Hypercholesterolaemia, ie. total serum cholesterol of >200 mg/dl [5.2 mmol/l] or high density lipoprotein cholesterol of <35 mg/dl [0.9 mmol/l], or on lipid-lowering medication

impaired fasting glucose, ie fasting blood glucose of >=110mg/dl confirmed by measurements on at least 2 separate occasions

obesity, ie, body mass index of >=30kg/m2 or waist girth of >100 cm

sedentary lifestyle, ie persons not participating in a regular exercise program or accumulating 30 minutes or more of moderate physical activity most days of the week

heart conditions

accepted recommended levels by recognised authorities, eg, Diabetes Australia, Cardiac Rehabilitation Association

Symptoms requiring interjection

pain, discomfort (or other anginal equivalent) in the chest, neck, jaw, arms or other areas that may be due to ischemia

shortness of breath at rest or with wild 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

complaint

weakness

acute inflammations, eg, signs and symptoms of bursitis and tendonitis

infections, eg, fever, temperature, redness

fractures

recent muscle injury, eg, hamstring tear

haematoma, ie, bruising or the potential bruising

torn ligaments, ie, joint instability

acute and/or sudden joint swelling

neck soreness/strain that result in symptoms of neurological origin in the arms and/or restriction of spinal movement

pain on movement of any body part

inability to bear weight through a limb

The Evidence Guide identifies the critical aspects, knowledge and skills to be demonstrated to confirm competence for this unit. This is an integral part of the assessment of competence and should be read in conjunction with the Range Statements.
Critical aspects of evidence to be considered
Assessment must confirm integrated demonstration of all elements of competency and their performance criteria, in particular, assessment must confirm the ability to
translate exercise prescription for clients with cardio-respiratory considerations into the practical exercise setting
explain and discuss with the client all aspects of the exercise prescription and reasons for inclusion of specific components in the context of the client's consideration
lead and instruct exercise for clients with cardio-respiratory considerations, both individuals and groups
monitor safe exercise practices and make corrections when appropriate
maintain exercise equipment, exercise aids and the exercise setting to ensure client safety
recognise and act on evidence that a client with cardio-respiratory considerations is not coping with exercise
demonstrate appropriate emergency procedures for a client with cardio-respiratory consideration experiencing an untoward event during exercise
demonstrate appropriate manner, attitude, empathy and patience when working with clients with cardio-respiratory considerations

Interdependent assessment of units
This unit must be assessed after attainment of competency in the following unit(s)
SRFAHN001A Make referrals and work collaboratively with allied health professionals where appropriate
SRFAHN002A Receive and respond to rehabilitation referrals from allied health professionals
SRFFIT010B Utilise a broad range of fitness equipment
SRFFIT016A Apply information from postural appraisals to fitness programs for moderate risk clients
SRFFIT018A Apply anatomy and physiology to fitness programs for moderate risk clients
SRFFSP003A Plan and deliver exercise to promote physical and psychological well-being in low to moderate risk clients
This unit must be assessed in conjunction with the following unit(s)
Nil
For the purpose of integrated assessment, this unit may be assessed in conjunction with the following unit(s)
SRFFSP006A Plan and deliver exercise strategies for musculoskeletal rehabilitation

Required knowledge and skills
Required knowledge
Anatomy and physiology
Exercise programming
Exercise strategies for specific populations
Required skills
Advanced verbal, written and listening skills for the age and values of the 'moderate risk' client with cardio respiratory needs, so that an appropriate and effective exercise plan can be implemented
Advanced Interpersonal skills to enhance the interaction with the client and to help with exercise adherence
Advanced programming and instructional skills so that the specific needs of the 'moderate risk' client with cardio-respiratory considerations are met

Resource implications
Physical resources - assessment of this competency requires access to
a real or simulated work environment
appropriate documentation and resources normally used in the workplace
'moderate risk' clients with cardio-respiratory considerations
Human resources - assessment of this competency will require human resources consistent with those outlined in the Assessment Guidelines. That is, assessors (or persons within the assessment team) should
be competent in this unit
be current in their knowledge and understanding of the industry through provision of evidence of professional activity in the relevant area
have attained the National Competency Standards for Assessment: BSZ401A, BSZ402A and BSZ403A

Consistency in performance
There is a wide range of potential clients with cardio-respiratory considerations. Thus, assessment should include clients of different ages with different types and severity of cardio-respiratory considerations. Due to issues such as safety requirements and deliver of appropriate techniques, this unit of competency must be assessed over a minimum of three (3), and preferably up to five (5), different occasions to include a range of clients with different risk factors and exercise settings to ensure consistency of performance over the Range Statements and contexts applicable to the work environment

Context for assessment
This unit of competency must be assessed in the context of health, functional capacity and physical activity for clients who have some type of physical and/or cognitive impairment due to a cardio-respiratory condition. This often requires adjustment of the standard exercise prescription and client approach to focus on functional capacity and health rather than physical fitness
This unit of competency should be assessed through observation of processes and procedures demonstrated by dealing with real clients, oral and written questioning on required knowledge and skills (especially how each cardio-respiratory consideration influences exercise capacity), and the manner and attitude when working directly with clients with cardio-respiratory considerations
Where performance is not directly observed or is required to be demonstrated over time or in different locations, evidence may be authenticated by supervisors or clients or other qualified individuals, provided that the person authenticating this evidence has directly witnessed his/her interactions with clients and is experienced working with clients with cardio-respiratory considerations, and that this authentication addresses issues specifically relating to delivery of exercise for clients with cardio-respiratory considerations

These levels do not relate to the Australian Qualifications Framework. They relate to the seven areas of generic competency that underpin effective workplace practices.

The three levels of performance (1, 2 and 3) denote the level of competency required to perform the task:



1. Use routine approaches

2. Select from routine approaches

3. Establish new approaches





Please refer to the Assessment Guidelines for advice on how to use the Key Competencies.
Communicating ideas and information
Discuss with client the role of physical activity in managing cardio-respiratory considerations, explain the different components of the exercise session and program (3)

Collecting analysing and organising information
Incorporate exercise prescription and information about client's health and cardio-respiratory considerations into planning and delivery of exercise session, instruction and discussion with client (2)

Planning and organising activities
Major responsibility for organising, leading and instructing exercise sessions in a safe and effective manner that addresses client's needs (3)

Working with others and in teams
Liaise with allied health professionals providing exercise prescription about client progress, responses and adaptations to exercise program (3)

Using mathematical ideas and techniques
Use of some quantitative techniques such as monitoring heart rate and rating of perceived exertion (2)

Solving problems
Monitor client's response to exercise and make adjustments appropriate to the client's needs, responses and cardio-respiratory considerations within the context of the exercise prescription (3)

Using technology
Use of exercise equipment, eg, free weights, weight machines, exercise machines, heart rate monitors (possibly), various exercise techniques (2)