What assessments are trainers using for special populations today?
I have been reading into different methods of evaluation and program design lately, and was interested in the different methods trainers and coaches are using today? A lot of this information is so "textbook" in my mind I want insight into the real-world application. More specifically I am interested in special populations like youth, seniors, pregnant women, and those with chronic conditions like arthritis, diabetes, high blood pressure, and others that you may have insight on. I have read a lot of literature on physiologic conditions, implications of exercise, and special considerations for different populations. I am really interested in the assessments chosen and how the results aided successful program design.
this is a very encompassing question, and I will give you my take on some of it.
While I have the standard NASM assessments tools on the chart that I use as a base for my evaluations, I rarely use many of them, and sometimes I make assessment criteria up as I watch the new client.
Where I tend to deviate the most from standards is when I deal with clients in post rehab from orthopedic problems or with neurological conditions which constitute the majority of my clients. Ultimately, an assessment is an inventory of abilities (or lack thereof) and obvious imbalances as far as can be seen. You do it when you do not know a person at all to be sure that you start off with a valid set of exercises that will not hurt the client. After that, every single workout is another assessment in a way, and I have often found techniques or exercises that I used subsequently to measure against.
For example, one of my clients with MS has no gluteal strength, and I have rigged and modified the exercises I know to see whether it is "MS" or just weakness. The hip bridge here was used as an assessment for strength and quality of movement. In other cases, it may be the ability to dorsiflex.
As said, I use the NASM assessment techniques as my base but am willing to throw it all out if it does not serve my purpose. Chances are that no two assessment are identical, and I do not follow a protocol but go my 'gut feel'. However, I document my findings very carefully, with photographs as necessary, so that I can re-create the parameters.
My mindset is a little different. I really believe that with each session, we are constantly assessing and evaluating our clients. With every bicep curl or squat we asking or client to perform, we are watching the whole body to see how it responds. From this we develop strategy and come up with corrective progressions and regressions. That's just what we do.
With that being said, I think that it is really important to have a systematic assessment process that each client follows. The very nature of an assessment process is to be able to make comparisons from one person to the next or some sort of established "norm." Now, knowing that, I kind of have a tiered approach when it comes to assessments.
I start everyone off with a structural integrity assessment. With each person, it is the same procedure. I start off at the toes and I work my way up to the head and neck, evaluating joint by joint for postural alignment. During this time, I am site not to just evaluate but to teach, as well. The success of my programs, regardless of the individuals goal, is an understanding of what and how their body is supposed to move.
That's kind of like my base that I do with everyone. From that base I can go one of many different directions to draw some conclusions. During my initial assessment and observation I may see deviations that get me thinking my client might have some unilateral dysfunctions and I head my evaluation in that direction. Or maybe after I finish my assessment I am still not certain of the severity of what I observed, I will run them through an FMS. The FMS, will give me a good idea of how my client moves and really might lead me in a direction of how to train them.
Irregardless of which assessment protocol you follow, you have to remember that a single assessment alone lacks validity. I think that when we talk about looking at the body as whole, there are a number of parts that can effect how we move. It really best to have a system that allows you be able to point a finger in the same direction in a number of ways.
In addition we are in the business of having people move. If we know anatomy really well, we can see when parts are of place and this can be a great assessment as well.
Hope this helps,
Karin, I think you worded it perfectly, "every single workout is another assessment in a way." I think this is great advice for an ideal mind frame to keep throughout sessions.
Janet, I agree with both you and Karin that pictures are a great tool to utilize for session progress and for the client's individual sense of accomplishment.
Jeremy, thank you for your detailed response. I appreciate your emphasis and enthusiasm for the whole, functional being in the coaching process.
I too find that pictures are wonderful tools, as well as video. I'll often share them with the client so they can see what I'm seeing. How they squat, hold a plank, their basic standing or sitting posture, etc. When the client sees themselves they see what I see and trust more in the processes I put in place for them. They can also see the kinetic chain in action and how one diviation can set a whole other set of changes into effect.
Great question. Really made me think of my processes.
Am I working with a group where time and measured numbers are important, or am I working with an individual who determines what they want to measure for themselves.
In a group I will measure the five components of fitness, so I have a front end measure and a back end. Additionally, with a group, I measure their individual waist circumference as that is an independent risk factor for CVD.
Measurements are determined by need, wants, or desires. Whatever the need you measure present levels, designed based on need, wants, or desires, and then measure again to make sure you are on path.
Assessments are tools. Just like using tools to repair a treadmill, you can't use them out of the order in which they are needed. Which, when, and why are the questions that will guide my process with each client.