Unit 10. Assignment 1. Health screening new clients prior to physical activity participation
Introduction:
I am studying to become a certified fitness instructor, and I have set up a work placement at my local
gym. As part of my training, I assess all new clients to verify their health and safety before they begin a
new workout programme. As part of the qualification, I am compiling a portfolio of evidence that
demonstrates my knowledge of health screening as well as my competence to conduct it.
Part A:
Factors that affect safe exercise participation:
Below will be a list of factors that can affect the safe participation of exercise in participants:
Exercise intensities, e.g., suited to health-related level, and ways of assessing exercise intensity,
such as % of maximum heart rate, rating of perceived exertion (RPE) rating, and training zones
for cardiovascular health and fitness
Factors affecting safe participation for specific groups:
Children, for example, should avoid heavy resistance workouts and small intervals of exercise
followed by rest periods.
Prenatal or postnatal women, for example, avoid high-impact and high-intensity activities,
stretch difficulties, limit abdominal exercises, and avoid supine exercise after 16 weeks of
pregnancy, isometric and overhead resistance workouts should be avoided.
Older people (50+), for example, a longer, more progressive warm-up period, a gradually
tapered cool-down, avoiding high-impact exercises, balance concerns, and including functional
life-related motions.
Exercise Intensity:
Appropriate to health-related level, Percentage of maximum heart rate, Rating of perceived exertion,
and Training zones for cardiovascular health and fitness:
Factors affecting safe participation for specific groups:
Children:
One factor that can affect safe exercise participation of children is heavy resistance training. There are
conflicting arguments as to whether children should do resistance training or not, but the term “heavy”
is a loose definition as it is very subjective to what people think “heavy” is. Not only does people’s
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,perception of heavy widely vary, but what heavy is to everyone also varies depending on how good their
muscular strength is. However, what is widely accepted is resistance training with weights that you can
only lift for 1-5 repetitions for is considered heavy strength training, no matter how much weight is
being lifted (Skwarecki, 2021; Anderson, 2020). So, children can still do weight training so long as they
can lift weights for more than 5 repetitions. This is not to say that children must always do more than 5
repetitions on each lift, but the focus is that the weight being lifted should be light enough so that the
weight can be lifted for 10 - 15 repetition without muscular failure (Kraemer, & Fleck, 1993). Also, much
research suggests that children benefit from strength training with appropriate supervision and strictly
adhered guidelines (Faigenbaum, 2000; Tsuzuku, Ikegami, & Yabe, 1998). With supervision and strict
guidelines, the benefits of strength training for children include increased lumbar spine and whole-body
bone mineral density (Guy, & Micheli, 2001), improved motor performance skills, enhanced sports
performance (Faigenbaum, 2000), enhanced strength and muscular endurance (Heinonen et al., 2000).
Research has previously been conducted with moderate intensity weight training on children as young
as 8 years old (latif Shaikh, 2016). This portrays how strength training can be beneficial to children as
there was a focus on intensity level over total weight lifted. Dr. Rob Raponi stated that children stunting
their growth from weightlifting results from “poor form, weights that are too heavy, and a lack of
supervision. But it is not the result of lifting weights correctly” (Bubnis, 2018). So, it can be concluded
from research that children can lift weights so long as they can lift the weight for 10 – 15 repetitions
under strict guidelines and supervision to ensure that children are safe during resistance training.
Without these guidelines and supervision, resistance training becomes unsafe for children and their
injury risk increases.
Additionally, child maturity can affect when and how children lift weights. If children are interested in
strength training, remind him or her that the goal is to improve muscle strength and endurance.
Improving muscular hypertrophy is a different story, and it is best done after adolescence, when your
child's bones are no longer expanding as growing children are not physiologically mature enough to
build lots of muscle mass. Weight training for children should only focus on eliciting neurological
responses, not hypertrophic responses as preteens can get stronger without gaining muscle mass, which
they will not get until after puberty. Strength training will help you develop stronger muscles but not
bigger if you have not gone through puberty yet. After puberty, testosterone, a male hormone,
increases muscle growth in response to weight training. Hypertrophy training can be conducted on
children who have fully gone through puberty as they will have testosterone which allows hypertrophy
to occur. If children have not fully gone through puberty, their weight training should only focus on
improving muscular strength and/or muscular endurance, not muscular hypertrophy (Gavin, 2022).
Excessive growth plate loading might stifle normal development activity. Mechanical disruption of the
growth plate can result in physiologic failure, which can stop normal bone formation. To put it another
way, bone growth may be slowed. Excessive growth plate loading differs from child to child depending
on their maturity and bone development. The effects of exercise are more sensitive in the growing
skeleton than in the mature skeleton. When a child's growth plate is subjected to compressive, tensile,
or shear loads, it adjusts to the mechanical demands and changes shape. More mature children will have
skeletal bones more like mature skeletons so they can undergo more stress without injury bone
development compared to other children their own age. Furthermore, longitudinal bone growth usually
occurs a year before peak gains in bone mineral content. Because the bone grows in length quicker than
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,it grows in width, there is a period of relative bone weakening following a growth spurt. During that
year, this area is prone to mechanical failure so this area should have less stress and loading placed
upon it (Fannin, 2021).
Another factor that can affect the safe exercise participation of children is appropriate work to rest
ratios. This is a crucial factor to consider mainly because both boys' and girls' anaerobic capacity
develops with age, but it is not fully formed until the age of 20 (Brandon, 2003). The main cause is a lack
of muscle mass. Children, on the other hand, have less glycogen stored per gramme of muscle and have
lower levels of phosphofructokinase, a key glycolytic enzyme. In addition, their creatine phosphate
reserves per gramme of muscle are reduced (Sharp et al., 1995). As a result, children are unable to
produce the low blood pH and high blood lactate levels associated with anaerobic activity (Malina,
1991). This means that children lack the natural fatigue mechanisms that adults have developed because
of intense effort. Trainers must be mindful of substantial danger considerations when training young
athletes at high intensities, including the fact that they tend to overheat more than adults. For example,
children may appear to be able to continue sprint interval training because they have not developed
severe acidosis, their muscles will still be fatigued, and they may be overheated if it is hot outside or
indoors. Because their energy consumption appears to rely more on oxidative metabolism, children are
better adapted to aerobic exercise than adults. The proportional proportion of fat utilisation during
prolonged exercise appears to be larger in children than in adults, indicating that glycolytic activity is age
dependent (Boisseau, & Delamarche, 2000).
Children's anaerobic ability is limited, so tough anaerobic exercise is not the most useful type of training
to them. When the body has attained its natural capacity, training for aerobic and anaerobic endurance
can begin in adolescence, and the benefits of this type of metabolic exercise will start to have a
significant impact (Brandon, 2003). This highlights the importance of ensuring that children get frequent
rest in between exercise as children will not produce as much lactic acid compared to adults and they
cannot buffer lactic acid as efficiently as adults due to their underdeveloped lactate system so the
frequent rest will reduce the likelihood of children over-fatiguing their muscles to the point where they
cannot exercise anymore. The rest allows their muscles to recover so that when they start to exercise
again, the levels of muscular fatigue should not be too high meaning that they can continue to not only
participate in exercise but enjoy the exercise. The rest will also allow the children's body temperatures
to decrease slightly to compensate for the fact that children have underdeveloped thermoregulatory
systems. Due to their small sweat glands, children have a low sweat output rate. In youngsters, a high
surface-to-body mass ratio increases heat absorption during activity under thermal stress, increasing the
likelihood of hyperthermia symptoms (Gomes, Carneiro-Júnior, & Marins, 2013). This again highlights
the need for plenty of rest intervals to be intertwined with work intervals. Research from (UKEssays,
2018) found that overuse injuries caused by repetitive micro-trauma are a new type of injury that has
emerged because of the surge in organised sports for teenagers. Injury prevention for overuse injuries
necessitates an understanding of the risk factors for injury, as well as suitable training regimen
adjustment and diversity, mechanical optimization with technique and equipment, and adequate
conditioning. Children do not have as developed anaerobic systems as adults, thus they do not produce
as much lactic acid and thus their muscles do not seize up after repeated bouts of exercise (Taylor,
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, 2018). This does not mean that children's muscles undergo less stress than adults’ muscles, but the
physiological signs of fatigue are smaller in children than adults. This needs to be considered when
training children because these minimised physiological signs of fatigue make it much easier to overtrain
children compared to adults so even if children do not seem very tired, they still need an adequate
amount of rest intervals to prevent overtraining and reduced repetitive micro-trauma.
Another factor that can affect the safe exercise participation of children is variety. Variety is important
because it can be key to preventing burnout for children. Research from Brenner et al (2016) found that
multiple sports engagement, at least until puberty, reduces the risk of injuries, stress, and burnout in
young athletes, and early diversification and later specialisation increases the likelihood of lifelong
sports participation, lifetime physical fitness, and possibly elite participation. This is because when
children specialise in one sport too early, overuse injuries occur as the same muscles, tendons, and
ligaments are repeatedly stressed in the same way using the same sporting techniques and motions
(Doyle, 2016). Not only does variety decrease the likelihood of burnout, but it can also increase
children’s creativity and make them less likely to stop participating in sport or exercise as variety
increases the focus of fun exercise participation over strict intensive exercise. A major problem that can
occur with specialising in one sport too early is that kids can often over-compete as they may play one
sport for their school team, an after-school community team and potentially a national team all during 1
season of sport. Although this may seem promising that the child has potential in their chosen sport or
activity, it will lead to burnout possibly through any of the following side effects: reduced athletic and/or
academic performance, personality or emotional changes, chronic muscle or joint discomfort, resting
heart rate that is too high, fatigue, a lack of passion, a lack of ambition, completing routines is difficult,
sleep patterns alter (more or less sleep than usual), and increased injuries, illness, or infections, as well
as decreased appetite and/or weight loss (University of Colorado School of Medicine, n.d.). Due to the
importance of ensuring that children avoid burnout through lack of varied sport and exercise activities,
trainers should periodise training to vary the training stimulus and promote long term fitness gains while
avoiding overtraining. Cross-training can also be implemented by varying workouts to focus on
conditioning, weightlifting, strength training, flexibility, or core building exercises. If you are teaching a
particular sport to children, you should consider implementing different drills each week to focus on
developing different skills as this will make the children more well-rounded with their overall skills whilst
working different muscles to execute different skills and techniques.
Another factor that can affect the safe exercise participation of children is costs. Research from Hagberg,
Lundqvist and Lindholm (2020) found that the estimated costs of exercise were between 14 and 37% of
net wages. For couples with only 1 child, this figure could easily be more than this estimate. This figure
will most definitely be higher for couples with multiple kids. To avoid cost being a barrier to the
participation of exercise to children, trainers could run exercise classes after school. This helps reduce
additional travel costs as the parents’ only need to get their kids to school and they save time as there is
no additional travel if exercise is available at school after school finishes rather than the exercise class
being in a leisure centre 10 miles away from school, for example. This also helps parents avoid
membership costs at gyms or leisure centres as the school sessions would be cheaper. Another way of
tackling the barriers of cost to children could be for the parents to pay a reduced fee for their children
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