Elements and Performance Criteria

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.
Client may include:
older
sedentary
overweight and obese
presenting with additional medical or psychological conditions.
Metabolic condition must include:
dyslipidaemias
obesity
hyperglycaemia
hyperinsulinaemia
pre-diabetes
hyperparathyroidism
diabetes Type I or Type II: controlled
polycystic ovary
Hyperthyroidism and or Graves Disease
Hypothyroidism
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 such as diabetes
smoking
hypertension; 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; 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; fasting blood glucose of =110mg/dl confirmed by measurements on at least 2 separate occasions
obesity; body mass index of =30kg/m2 or waist girth of > 100cm for males, = 88cm for women or waist/height ration of = 0.5 cm
sedentary lifestyle; 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.
Goals and needs analysis may include:
timeframes
appropriate exercise program adjustments
barriers
motivation.
Methods to enhance exercise adherence may include:
rewards for attendance and participation
statement of intent
perceived choice
goal setting.
Potential barriers may include:
perceived versus actual barriers
initial low fitness level and probable overweight or obesity
time and access to facilities
self-consciousness in client
concerns for health.
Fitness assessment may include:
range of movement
strength
girth measurements
body mass.
waist to height ratio.
Muscular conditioning may include:
muscular strength
muscular power
muscular endurance.
Records may include:
electronic
hand written.
Exercise program may include:
exercise selection
exercise sequence
exercise variety
logical progression.
Exercise equipment may include:
cardiovascular equipment:
stepper
rowing machine
stationary bicycle
treadmill
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'
possible fluctuations in blood glucose levels and dehydration.
Symptoms requiring intervention may include:
shortness of breath at rest or with mild exertion
dizziness or syncope
orthopnea or paroxysmal nocturnal dyspnea
palpitations or tachycardia
symptoms of hypoglycaemia and hyperglycaemia
intermittent claudication
unusual fatigue or shortness of breath with usual activities
illness or sickness
unaccustomed lack of functional strength
soreness or strain
pain on movement of any body part.
Procedures to respond to symptoms requiring intervention must include:
cessation of activity
first aid
emergency medical assistance
referral.
Signs of unstable condition may include:
fatigue and weakness
cardiac pain
breathlessness
oedema
palpitations
claudication pain
dizziness.
Negative health effects may include:
eating disorders:
bulimia
anorexia
obesity
diabetes
hypertension
cardiovascular disease
cancer
joint degeneration.
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.
Endocrine system may include:
role and function of the endocrine system
endocrine glands
pituitary
adrenal
parathyroid
pancreas
gonads
thymus
hormones
types
hormone transport in the blood
hormone action
control of hormone action
control of hormone secretion
abnormal secretion
role of endocrine system in stress and disease
effects of ageing on the endocrine system
disorders or homeostatic imbalances
diabetes.
Hormones may include:
human growth hormone
anti-diuretic hormone (vasopressin)
calcitonin
aldosterone
insulin.
Nervous system may include:
divisions:
central nervous system
peripheral nervous system:
somatic nervous system
autonomic nervous system
central nervous system:
brain
spinal cord
peripheral nervous system:
cranial nerves
spinal nerves
peripheral nerves
plexus
neurons:
afferent
efferent
motor
sensory
histology of nerve tissue:
neuron:
axon
dendrites
nucleus
cell body
node of ranvier
neurilemma
myelin sheath
scwann cell
neuroglia
brain:
structure
brain stem
cerebral hemispheres
ventricles
cranial nerves
meninges
cerebrospinal fluid
blood supply:
sensory areas and pathways
motor areas and pathways
nerve impulses:
resting membrane potentials
graded potentials
action potentials
refractory period
subthreshold stimulation
all or none law
summation:
spatial
temporal
neuromuscular transmission:
neuromuscular junction
transmission
synaptic transmission:
synapse
excitation at synapse
inhibition at synapse
spinal reflexes:
reflex arc
receptors
reflex action
types of reflexes
spinal cord:
structure
spinal nerves
peripheral nerves:
cervical plexus
brachial plexus
lumbosacral plexus
regeneration and repair of nervous tissue
effects of ageing on the nervous system
disorders of the nervous system:
multiple sclerosis
epilepsy
nerve injuries
cerebrovascular accident
sensory receptors:
interoreceptors
exteroreceptors
sensory organs:
eye:
structure
accessory organs
vision:
formation of image
proprioreceptors:
visual acuity
visual fields
visual pathways
visual defects
ear:
structure
hearing
conduction of sound
auditory pathway
hearing defects
equilibrium
Moderate risk clients may include:
chronic disease state
medical condition or injury
under prescribed medication
symptoms of cardiorespiratory disease
those identified by medical or allied health professionals
older and sedentary.
Digestive system may include:
structure:
mouth
oesophagus
stomach
small intestine
large intestine
rectum
anus
sphincters
glands:
salivary glands
pancreas
liver
gall bladder
blood supply
innervation
role in energy production
digestion:
breakdown
motor functions:
mastication
peristalsis
segmentation
deglutition
gastric motility
intestinal motility
secretion of enzymes
secretion of juices
enzymes:
secretion
function
absorption:
carbohydrate
lipids
protein
water and electrolytes
vitamins
chemical composition of foods
metabolism of foodstuffs:
oxidation of food
by-products
storage
regulation of metabolism:
choice of metabolic pathway
carbohydrate metabolism
fat metabolism
protein metabolism
Medical conditions and disorders may include:
conditions affecting the endocrine system:
diabetes
conditions affecting the nervous system:
retinopathy
peripheral neuropathy
quadriplegia
paraplegia
cerebral palsy
muscular dystrophy
Parkinson's disease

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 professionals regarding relevant health and functional status of the referred clients and discusses aspects of exercise prescription with clients.
when appropriate, reacts to adverse events to deal with exercise program problems and issues.
correctly interprets the exercise prescription and make modifications consistent with prescribed parameters and scope of practice
safely and effectively delivers exercise for referred clients with cardiorespiratory conditions and recommends appropriate alterations according to client's physical and motivational response
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.
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 metabolic conditions.
Assessment must also ensure access to:
a range of clients with real or simulated metabolic conditions from a range of ages
a range of real or simulated medical or allied health professionals referrals for a range of referred clients with metabolic conditions and risk factors
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 a range of metabolic conditions
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 in consultation with an appropriate medical or allied health professional to account for a range of needs 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 or written questioning to assess knowledge of the physiology of metabolic conditions and associated risk factors and the use and effect of medications
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, for example:
SISFFIT523A Deliver prescribed exercise to clients with cardiorespiratory conditions
SISFFIT530A Deliver prescribed exercise to children and young adolescents with specific chronic conditions