USP102X Fitness testing

USP102X Fitness testing Unit reference number: J/507/5592 Level: 3 Guided Learning (GL) hours: 60 Overview The unit provides learners with the knowledge and skills to conduct fitness tests and health screening and monitoring assessments. Learners will develop their knowledge of a range of laboratory-based and field-based fitness tests and a range of health screening and monitoring assessments. Learners will develop their skills to select and administer appropriate assessments safely and effectively, taking account of the client s needs and validity and reliability of the assessments. Learners will also develop the knowledge and skills to interpret results against normative data and provide feedback on how fitness can be improved. Learning outcomes On completion of this unit learners will: LO1 Know a range of fitness tests and health screening assessments LO2 Be able to conduct health screening assessments and administer fitness tests LO3 Be able to interpret results of health screening and fitness tests and provide feedback to the client on how to improve fitness Version 8 1

Assessment requirements Learners must produce a portfolio of evidence which includes: 1. Service portfolio 2. Summative practical assessment 1. Service portfolio Learners must produce a service portfolio that includes evidence of health screening and monitoring and laboratory-based and field-based fitness tests. At a minimum the service portfolio for this unit must include client health screening and fitness profiles covering all the following: Worked with a minimum of 2 contrasting sports people/clients Collected a minimum of 1 health screening test method on each person e.g. PAR-Q Used a minimum of 3 health monitoring tests on each person - Resting heart rate - Resting blood pressure - Lung functions - Waist-to-hip ratio - Body mass index (BMI) Used a minimum of 1 test for each component of fitness on each person - Cardiovascular fitness - Muscular fitness - Performance/skill-related fitness - Flexibility - Body composition Completed a description of test results, levels of fitness and an interpretation of results against normative data (where appropriate) Evidence from one summative practical assessment must also be presented in the service portfolio. The service portfolio must be completed prior to learners undertaking the summative practical assessment. 2. Summative practical assessment Learners must select and safely administer a range of health screening and monitoring assessments for a selected individual. Learners must achieve all assessment criteria in order to pass and achieve the unit. The summative practical assessment must take place in a real or realistic working environment on a real or realistic client. At a minimum the summative practical assessment for this unit must cover: Health screening procedures Informed consent record Fitness testing of a selected individual 2

Administration of the following health and fitness assessments using validated and recognised protocols - Resting heart rate - Resting blood pressure - Anthropometrics - Body composition - Lung function - Cardiovascular fitness - Flexibility range of movement - Muscular strength - Muscular endurance - Motors skills/performance A record of results Interpretation of results against normative data Feedback and guidance Recorded professional discussion can also be used as an assessment method attached to the practical assessment and is particularly useful for gathering evidence for criteria related to evaluation and reflection. Professional discussions should be planned and recorded. 3

Unit content LO1 Know a range of fitness tests and health screening assessments Explain the purpose of health screening, monitoring and fitness testing: Purpose - Baseline measure of information Assess health Assess fitness - Use information to set training goals and health targets - Identify reasons for referral or deferral to other professionals GP Personal trainer Sports coach How to select appropriate tests/assessments - Consideration of client needs, e.g. injuries or physical limitations, health status, medical conditions. Estimated current fitness from other information gathered, e.g. lifestyle, current participation in sport and exercise, demands of sport - Purpose of assessment reason why it is needed. This may render some assessments non-essential and unnecessary for some clients and in these instances the assessments should be excluded, e.g. the use of skin calipers for a client who is visibly obese, may be insensitive and invasive - Components of fitness to be measured - Component of health to be assessed Describe fitness tests used to assess different components of physical fitness: Cardiovascular fitness (assessments and protocols) - Maximal versus submaximal tests - Treadmill based tests Bruce protocol, modified Bruce, Balke-Ware, modified Balke, ramp - Cycle ergometer tests Astrand, YMCA - Field-based tests multi-stage fitness test, Rockport 1 mile walk, Brigham Young University jog test, 1.5 mile run test, Queens College step test, Sharkey (forestry) step test, Chester step test Muscular fitness - Muscular strength Static hand grip dynamometer, cable tensiometers Dynamic repetition maximum Isokinetic muscle testing at constant speeds. - Muscular endurance Press-up test timed Abdominal curl test timed YMCA bench press Muscular endurance test battery Core muscle tests plank, supine bridge Repetition maximum (15RM) - Muscular power Standing broad jump Vertical jump 4

Repetition maximum (1RM/6RM/8RM) Power clean/snatch Margaria-Kalamen test Performance and skill related fitness - Balance/proprioception Standing stork test Reaction time (reaction time ruler test) Romberg s test Star excursion balance test - Speed 35m speed test 60m speed test - Agility T-test Hexagon test Illinois agility run test Hurdle jump - Anaerobic Power Wingate cycle test 300m run Flexibility - Sit and reach - Individual joint assessment - Goniometry Body composition - Skinfolds - Bioelectrical impedance - Hydrostatic weighing - Air-displacement plethysmography - Circumference measurements. The advantages and disadvantages of different tests: - Validity extent to which the test actually measures what it is supposed to, specificity of assessments - Reliability extent to which the test could be repeated by another tester and the same result achieved - Accuracy test variables, such as time of day, tester skills, use of protocols, order of tests, pre-test warm up; individual factors, e.g. clothing, test experience/practice, food eaten, other training participated in on previous days - Suitability for different needs, e.g. injury of medical conditions may make some tests inappropriate/unsafe - Practicality environment and space, cost - Time needed to complete tests - Equipment including calibration - Facilities - Number of individuals who can be tested at the same time 5

Describe health screening and health monitoring assessments: Health screening - PARQ, PARmedX - Risk assessment and stratification for cardiovascular, pulmonary and metabolic disease (see ACSM risk stratification model) - Medical evaluation (GP) - Informed consent requirements prior to assessment - IPAQ (activity levels) - EQ-5D (wellbeing) Health monitoring tests: - Resting heart rate - Resting blood pressure - Lung function (peak expiratory flow (PEF) - Forced vital capacity (FVC) - Forced expiratory volume in one second (FEV1) - Ratio of FEV1 to FVC - Height /weight - Waist circumference measurement - Waist-to-hip ratio - Body mass index (BMI) - Bio-electrical impedance analysis - Functional assessments - Posture The advantages and disadvantages of different tests: - Validity - Reliability - Accuracy test variables, such as time of day, tester skills, use of protocols, order of tests, pre-test warm up; individual factors, e.g. clothing, test experience/practice, food eaten, other training participated in on previous days - Suitability - Practicality environment and space, cost - Time needed to complete tests - Equipment including calibration Correct order of assessments - Health screening, resting heart rate and blood pressure and informed consent prior to any further assessments - Cardiovascular assessments before flexibility assessments to ensure muscles are warm 6

LO2 Be able to conduct health screening assessments and administer fitness tests Select health screening and fitness assessments appropriate for the individual: Selection based on client s needs and goals Consideration to: - Type of sport (where relevant) - Sport specific team or individual sports person (where relevant) - Playing positions (where relevant) - Levels of fitness - Ability - Components of fitness. - Individual needs, e.g. any exclusions, such as injury Assessments: - Resting heart rate - Resting blood pressure - Anthropometrics (height and weight/body mass index/bmi/waist circumference/waist to hips ratio) - Body composition (skinfold callipers/bio-electrical impedance) - Cardiovascular fitness (Astrand bike test/rockport walking test/step test/cooper 12 minute walk/run) - Flexibility range of movement (sit and reach test/visual assessment during stretch positions) - Muscular strength - Muscular endurance - Motors skills/performance (balance, agility, speed, reaction time or power) Explain suitability of assessments as part of the informed consent process - Purpose to provide the client with the information they need to make an informed decision regarding their participation in fitness assessments, to provide the client the opportunity to reflect on verbal and written information provided, to check the client s understanding, legally admissible evidence - Process explain the reasons for informed consent, inform the client of the types of assessments and the purpose for using these assessments and their relevance to the client s goals, the benefits and risks of the planned assessments, respond to client questions, recording signed consent, secure and confidential storage of written informed consent - Content of informed consent record contents aims, benefits, risks, responsibilities of client and instructor, record of questions and answers, date and signatures of client and instructor 7

Conduct health fitness tests using validated and recognised protocols: Gain informed consent prior to any assessment Administration of the following health and fitness assessments using validated and recognised protocols: - Resting heart rate - Resting blood pressure - Anthropometrics (height and weight/body mass index/bmi/waist circumference/waist to hips ratio) - Lung function (peak expiratory flow (PEF); forced vital capacity (FVC); forced expiratory volume in one second (FEV1); ratio of FEV1 to FVC); - Body composition (skinfold callipers/bio-electrical impedance) - Cardiovascular fitness (Astrand bike test/rockport walking test/step test/cooper 12 minute walk/run) - Flexibility range of movement (sit and reach test/visual assessment during stretch positions) - Muscular strength - Muscular endurance - Motors skills/performance (balance, agility, speed, reaction time or power) Give consideration to: - Pre-test procedures and explanation guidance to client - Test sequence and protocols - Contra- indications to testing - Reasons to terminate test - Test environment Use appropriate communication skills throughout the assessment - Verbal and non-verbal communication to meet client needs and check on client experience and how they are feeling - Encourage the client to speak openly and provide feedback e.g. use positive and open body language, relevant open questions, active and empathic listening and reflective statements - Respond to client questions and provide appropriate answers, e.g. explaining the purpose of health screening and the specific fitness assessments used; and any of the reasons for the inclusion or exclusion of any assessments See other assessments listed in LO1 Record results of health assessments and fitness tests: Record results - Appropriate method (data collection sheet) - Correct unit of measurement - Process raw data (test result converted to predicted VO 2 max etc) Consideration to data protection 8

LO3 Be able to interpret results of health screening and fitness tests and provide feedback to the client on how to improve fitness Interpret results of health screening and fitness tests: Interpret results against of health screening tests against normative data (significance for health) Interpretation considerations for health screening reasons for referral or deferral of exercise/sport and fitness assessment: - Clients who need to be referred or signposted Positive, yes response to one or more PAR-Q questions signpost to GP Contra-indications (high blood pressure, irregular heart rate) signpost to GP Multiple cardiovascular disease risk factors (CVD) signpost to GP Injuries signpost to GP, physiotherapist, sports therapist - Clients who need temporary deferral Feeling unwell, minor illness, e.g. colds, minor injuries, e.g. muscle strain, excessive fatigue Client presents with inappropriate clothing, footwear or equipment Client ready to participate Apparently healthy, negative, no responses to PAR-Q Interpretation considerations for health monitoring - Use of national guidelines for specific assessments, e.g. blood pressure, waist circumference (NICE, Department of Health) - ACSM reference Interpretation for fitness - Against normative data published data interpretation tables; selection of data tables; accepted ranges for health; norms for sports performers, and elite athletes; significance of results. - ACSM reference Explain results of health screening and fitness test results: Explanation of results - Highlight strengths and weaknesses - Areas for improvement - Goal setting - Recommendations Provide feedback that is: - Timely immediately after testing - Factual, accurate, positive and constructive language to explain outcomes - Sensitive to client feelings and needs no shaming Maintain confidentiality Maintain accurate records of assessment Make suggestions for exercise recommendations to develop specific components of fitness: - Muscular fitness: ACSM guideline for frequency, intensity, time Bodyweight resistance exercises (pull ups, chin ups, press ups, lunge, squat, abdominal curl, plank, back raise, triceps dips) 9

Resistance machines Cable machine exercises Free weights - Cardiovascular fitness: ACSM guideline for frequency, intensity, time and type Running, swimming, cycling, walking, dancing Bodyweight cardiovascular exercises step-ups, running on spot, sprints, mountain climbers, burpees, jumping jacks, lunges Cardiovascular machines upright cycle, recumbent cycle, treadmill, stepper, rowing machine, elliptical trainer, cross trainer Variables of different machines: level, intensity, strokes per minute, revolutions per minute, kilometres per hour, step speed, incline, decline, impact, range of motion, muscle groups emphasised - Flexibility: ACSM guideline for frequency, intensity, time and type Types: static maintenance (short duration) and developmental stretching (extended duration 15-30 seconds), dynamic (range of movement) stretching Stretching exercise positions standing, sitting, kneeling or lying Assisting aids wall, step, strap, towel, gravity - Motor skills: Specific to skill, e.g. speed, agility, reaction time, power, co-ordination, balance Activities of daily living: - Active travel - Walking - Climbing stairs - Gardening - Desk breaks - Moving more often and sitting down less 10

Employability skills to be demonstrated throughout the practical assessment Professionalism: Adhere to industry codes of ethical practice Wear appropriate clothing and footwear Present a positive image Communication: Adapt and tailor their communication approach for different clients: - New and existing clients - Special populations (young people, older adults, ante- or post-natal women, disabled people) - Clients with other needs, e.g. speakers of other languages, deaf or partial hearing, blind or partially sighted Communication considerations show sensitivity to clients with different communication styles: - Verbal communication speaking manner and tone of voice, being supportive, respectful, sensitive to client, open questioning to gather information related to treatment, active listening Advantages of verbal communication quick, instant response, client body language Disadvantages of verbal communication no written record, no time to consider your reaction, no paper trail - Non-verbal communication awareness to eye contact, body language, gestures, facial expressions Advantages of body language expression/refection of feelings, unconscious, others can easily identify anger, happiness, confusion Disadvantages of body language cannot hide feelings (can be an advantage that these are visibl, e.g. if a client flinches to show discomfort then this enables the therapist to respond), can be a barrier to communication Customer service: Principles of customer service quality, keeping promises, managing customer expectations, customer satisfaction, speed of service, follow organisation procedures for meeting and greeting and inducting clients to equipment Examples of good practice in customer service meeting and exceeding customer needs and expectations, adding a personal touch, providing personal attention, knowing client names, using polite language, making extra efforts to demonstrate willingness to please the customer, treating the customer as an individual Dealing quickly and effectively with a complaint, acknowledge complaint immediately (HEAT Hear, Empathise, Apologise, Take action), handle complaints (privately, positively, confidently, professionally, promptly, confidentially, empathetically, with trust and respect, to client s satisfaction), follow agreed procedures to check complaint has been dealt with The importance of customer service to a business - professional image, organisation and industry sector, customer retention, customer satisfaction, customer relationships and repeat business, including word of mouth recommendations and referrals 11

Commercial awareness: Eco-friendly and cost-efficient use of resources, e.g. time, disposal of waste, use of products and consumables - Use of non-toxic and ecologically friendly cleaning products - Recycling paper towels - Shredded assessment cards and other documents - Turning equipment and air conditioning off overnight Opportunities to promote and sell additional products and services: - Personal training sessions - Sports massage - Lifestyle support - Specialist courses or sessions, e.g. weight management, healthy eating, back care - Group exercise - Treatment products Opportunities to promote other activities and services offered by the facility, e.g. group exercise and studio classes, swimming, racquet sports, sports massage, physiotherapist, nutritionist, café, beauty therapy Awareness of competitors - Different business types locally that may compete for a client s disposable income Unique selling points of products and services. Combination of facilities and services offered that are not available elsewhere. Specialities and target market niches Opportunities to differentiate self and services from competitors. Own experiences and achievements relevant to supporting others 12

Assessment criteria In order to pass this unit, learners must achieve all pass criteria. The pass criteria relate to the proficient demonstration of skills and knowledge. Learning outcome The learner must: LO1 Know a range of fitness tests and health screening assessments LO2 Be able to conduct health screening assessments and administer fitness tests LO3 Be able to interpret results of health screening and fitness tests and provide feedback to the client on how to improve fitness Assessment Criteria The learner can: P1 Explain the purpose of health screening, monitoring and fitness testing P2 Describe fitness tests used to assess different components of physical fitness P3 Describe health screening and health monitoring assessments P4 Select health screening and fitness assessments appropriate for the individual P5 Conduct health fitness tests using validated and recognised protocols P6 Record results of health assessments and fitness tests P7 Interpret results of health screening and fitness tests P8 Explain results of health screening and fitness tests 13

Assessment guidance Assessors must use the amplified assessment guidance in this section to judge whether assessment criteria have been achieved. P1 Explain the purpose of health screening, monitoring and fitness testing Learners must be able to explain the purpose of health screening and fitness testing. They should explain what the information can be used for as well as any general benefits or general disadvantages of health screening and assessment, for example, the extent to which it may motivate or demotivate individuals and the relevance of some normative data for specific needs. P2 Describe fitness tests used to assess different components of physical fitness Learners must describe a range of fitness tests for different components of fitness. Learners must describe the advantages and disadvantages of the specific methods with consideration to validity, reliability, accuracy, equipment required, cost and variables that affect assessment, such as tester skills and reasons for any exclusions, e.g. injury of a specific joint may make some assessments contra-indicated. P3 Describe health screening and health monitoring assessments Learners must describe a range of health screening and monitoring assessments. Learners must describe the advantages and disadvantages of the specific methods with consideration to validity, reliability, accuracy, equipment required, cost and variables that affect assessment, such as tester skills. P4 Select health screening and fitness assessments appropriate for the individual Learners should select appropriate tests to meet the needs of the individual. Resting heart rate Resting blood pressure Anthropometrics (height and weight/body mass index/bmi/waist circumference/waist to hips ratio) Body composition (skinfold callipers/bio-electrical impedance) Cardiovascular fitness (Astrand bike test/rockport walking test/step test/cooper 12 minute walk/run) Flexibility range of movement (sit and reach test/visual assessment during stretch positions) Muscular strength Muscular endurance Motors skills/performance (balance, agility, speed, reaction time or power) The selected tests should be listed as part of the informed consent record and their suitability explained to the client. 14

P5 Conduct health fitness tests using validated and recognised protocols Learners must explain the assessment process and gain informed consent from the client prior to conducting any assessment; this record should be signed by the client and the learner conducting the assessment. Learners should administer the following health and fitness assessments using validated and recognised protocols: Resting heart rate Resting blood pressure Anthropometrics Body composition Lung function Cardiovascular fitness Flexibility range of movement Muscular strength Muscular endurance Motors skills/performance A record of results Learners must ensure that the health monitoring tests are carried out in an appropriate area where privacy, confidentiality and accuracy can be preserved. Learners should carry out the fitness tests in an appropriate environment tailored to the person being tested, with consideration to health and safety in the environment, e.g. temperature. Learners must use chosen methods and procedures to record the findings of both the health screening and monitoring and fitness test results. All information should be recorded. P6 Record results of health assessments and fitness tests Learners must record the findings of the individual s health and fitness tests. This may be done electronically or on paper. Learners must include normative data for fitness tests. P7 Interpret results of health screening and fitness tests Learners must use published data tables to compare the results of the fitness tests and appropriate guidance, e.g. NICE blood pressure, body composition, to compare the results of health assessments. P8 Explain results of health screening and fitness tests Learners must explain the results of the fitness tests to the individuals. Learners must explain how results compare with normative data or relevant health guidelines and provide recommendations for improvements based on areas of strength and weakness. Feedback should be provided with sensitivity, it should also be factual, accurate and constructive. 15

Resources The special resources required for this unit are access to a real or realistic working environment which supports the undertaking of health screening and fitness testing. Best practice should be encouraged by giving learners the opportunity to work on real clients and in real environments, e.g. sports and fitness clubs and personal training studios with individuals requiring health screening and fitness tests. However, as this is not always possible and may create barriers to assessment, learners may carry out treatments on peers (realistic clients). Learners must also have access to consultation documentation, resources to aid health screening and fitness testing. Learners should also be directed to information that allows them to access norm values and standardisation of test protocol. Recommended text books: ACSM (2014). ACSM s Guidelines for Exercise Testing and Prescription. 9 th ed. American College of Sports Medicine. Wolters Kluwer/Lippincott Williams & Wilkins. Philadelphia. USA. Bursztyn, P (1990) Physiology for Sports People. A serious user s guide to the body. USA. Manchester University Press. Coulson, M (2011) The Complete Guide to Personal Training. Bloomsbury Publishing. London. UK. Fleck, S.J, and Kraemer, W.J (1997) Designing Resistance Training Programmes. 2 nd ed. Human Kinetics. USA. Golding, L et al (1989) Y s Way to Physical Fitness. The Complete Guide to Fitness Testing and Instruction. USA.YMCA Lawrence, D & Hope B (2011) The Complete Guide to Circuit Training. UK. Bloomsbury Publishing. McArdle, W.D. Katch, F.I. and Katch, V.L (1996) Exercise Physiology. Energy, Nutrition and Human Performance. USA. Lea and Febiger Norris, C (2007) The Complete Guide to Stretching. 2 nd edition. UK. A&C Black/Bloomsbury Publishing. Norris, C (2011) The Complete Guide to Sports Injuries. UK. A&C Black/Bloomsbury Publishing. Norris, C (2013) The Complete Guide to Exercise Therapy. UK. A&C Black/Bloomsbury Publishing. Paine, T (2000) The Complete Guide to Sports Massage. 2 nd edition. UK. A&C Black/Bloomsbury Publishing. Sharkey, B (1990) Physiology of Fitness. 3 rd Edition. Champaign, Illinois. USA. Human Kinetics. NB: This list is not exhaustive. There are many other valuable text books. Websites: The National Institute for Health and Care Excellence (NICE): www.nice.org.uk The American College of Sport Medicine (ACSM): www.acsm.org The Department of health: www.gov.uk/government/organisations/department-of-health The British Association of Sport and Exercise Science: www.bases.org.uk The SMA Code of Ethics and Conduct: www.thesma.org Institute of Sport and Remedial Massage - www.theisrm.com/terms.php 16

Complementary and Natural Healthcare Council (CNHC) - www.cnhc.org.uk Federation of Holistic Therapists (FHT) - www.fht.org.uk The council for soft tissue therapies - www.gcmt.org.uk Delivery guidance Teachers are encouraged to use innovative, practical and engaging delivery methods to enhance the learning experience. Learners may benefit from: Work experience within a setting where they can shadow other professionals conducting fitness and health assessments, with the opportunity to work under supervision (where practicable) and practise to hone their skills in a real environment Using interactive information and technology systems and hardware so they can learn about fitness testing and assessment methods, including access to software used to interpret results and feedback Practical workshops where they practise a range of fitness tests and health assessments working with peers and receiving feedback from a teacher Discussion groups where they can explore the advantages and disadvantages of different assessments. Discussion workshops where they can explore the validity and reliability of different assessments, including the variables that may affect accuracy Discussion workshops where they can explore test protocols and guidelines Use of case studies and tutor led presentations with interaction to explore the recommendations and feedback that can be suggested in relation to test outcomes (within role boundaries) Opportunities to practise giving feedback on test outcomes Links with other units In the VTCT Level 3 Diploma in Massage and Therapies for Sport, this unit is closely linked with the following units: USP92M Anatomy and physiology for sports massage Learners will be required to apply their knowledge of anatomy and physiology when studying fitness testing. The underpinning knowledge of anatomy and physiology will provide the learner with the ability to interpret and evaluate test results and formulate training programs to facilitate further improvements in various components of fitness. The content of the anatomy and physiology unit should be delivered before the fitness testing unit. USP93M Professional practice in sports massage Learners will be required to apply their knowledge of professional practice when conducting fitness assessments. Learners will be expected to work professionally and ensure their conduct meets with industry codes of practice and ethical guidelines. The content of the professional practice unit should be delivered before the fitness testing unit. USP94M Assessment for sports massage Learners will be required to apply their knowledge of assessment for sports massage when conducting fitness assessments. Consultation and assessment are legal requirements of the role and failure to consult properly with the client prior to and treatment or recommendations could invalidate therapy insurance. The content of the assessment for sports massage unit may be delivered before or integrated with the delivery of the fitness testing unit. 17

USP95M Sports massage treatment Learners will be required to apply their knowledge of sports massage treatments when studying fitness testing. This will ensure the complete service and all recommendations are holistic and fully meet the client needs. The content of the sports massage treatments unit should be delivered before the fitness testing unit. USP96M Understand the principles of soft tissue dysfunction Learners will be required to apply their knowledge of soft tissue dysfunction when studying fitness testing. Soft tissue dysfunction may render some assessments inappropriate and learners will need to seek alternative approaches, which may include signposting and referral to other professionals. The content of the principles of soft tissue dysfunction unit should be delivered before the fitness testing unit. USP97M Health and lifestyle Learners will be required to apply their knowledge of health and lifestyle when studying fitness testing. Knowledge of health and lifestyle can assist the learner with interpretation of health screening data and broaden their ability to offer advice and guidance. The content of the health and lifestyle unit should be delivered before the fitness testing unit. In the Level 3 Diploma in Personal Training and Behaviour Change, Level 3 Extended Diploma in Personal Training and Behaviour Change and in the Level 3 Diploma in Exercise Science and Personal Training, this unit is closely linked with the following units: USP111M Applied anatomy and physiology for exercise and health science Learners will be required to apply their knowledge of anatomy and physiology when learning about fitness testing. The content of the applied anatomy and physiology unit should be delivered before delivery of the fitness testing unit. USP56M Programming personal training with clients Learners will be required to know and apply some health and fitness testing methods when learning how to programme personal training. The content of the programming personal training unit can be delivered before or integrated with the delivery of the fitness testing unit. USP57M Delivering personal training sessions Learners will be required to apply their knowledge and skills of fitness testing when delivering personal training and reviewing personal training programmes with clients. The content of the delivering personal training unit can be delivered before or integrated with the delivery of the fitness testing unit. USP59M Behaviour change and adherence Learners will be required to apply their knowledge and skills of behaviour change when learning about fitness testing. The content of the behaviour change and adherence unit can be delivered before or integrated with the delivery of the fitness testing unit. 18