Panel Discussion: What Assessments Do You Use, and Why?
Movement assessment, cardiovascular assessment, motivational assessment, PAR - Q, etc.
Moderated by Brent Brookbush DPT, PT, MS, PES, CES, CSCS, ACSM H/FS
This Panel Discussion was originally posted on my facebook page - https://www.facebook.com/brent.brookbush - on April 30th, 2010
Scott Pullen, April 29 at 1:11pm: When defining the reason for being there, I often used a visualization exercise to get at the heart of the "why and why now" for them being there. Then typical movement assessments to see what they do, how they do it and to illustrate just a touch of what they need and how I can help.
Brent Brookbush, April 29 at 3:58pm: Goal setting is the corner stone of behavior modification research. I love the idea of visualization for the development of those goals, and I can't even begin to think where I would be without movement assessments for establishing need.
Mikal Payne, April 30 at 10:13am: OK, here we go, 3 and 4 site skin fold, 3 or 4 site circumference, flexibility, 1 or 3 RM( age dependent and last time weights were used), Rock-port walking or bike for cardiovascular and the good old talk test. BP just as a reference point. Always have new fill out a PAR-Q and go over it with them verbally. Short-term goals.
Mikal Payne, April 30 at 10:15am: Oh and posture more visual, then a physical test.
Brent Brookbush, May 1 at 12:27pm: Great set of tests Mikal… I must ask two questions humbly…
Brent Brookbush, May 1 at 12:31pm: 1. Is a 1 or 3 rep max test a good choice when we consider the risks involved and the relatively small impact test results have on our program? For example, why not a 10 rep max test, or a "chest exercise progression" test that takes a client through a progression of exercises to determine relative stability, and the exercises to be used in the next set of routines.
Brent Brookbush, May 1 at 12:33pm: 2. If you do not write down the physical results of a posture test how do you objectively measure change? I know this seems like a small point, but it is important to be as accurate as possible. Sometimes big changes in performance come from relatively small changes noted in a dynamic postural assessment.
Mikal Payne, May 1 at 8:12pm: Question 1 - I do not know that much about a 10 RM test, my choice of a 3 RM test has more to do with pop. I teach, older adults for some reason feel strength does not hold up with aging.
Mikal Payne, May 1 at 8:15pm: and question 2-Good point I do keep records on my clients who want a posture test but generally I just watch general club members move through a series of exercise and make correection then just keep an eye out/on them as they workout.
Mikal Payne, May 1 at 8:18pm: I have tried to add posture analysis to an orientation and did not get good feedback from the general membership. Change seems to be a bad thing at a gym/fitness center, people and their patterns.
Brent Brookbush, May 2 at 1:07pm: Hey Mikal, the problem with postural analysis and corrective exercise is implementation. You have to make it simple, effective, and be able to communicate the "value add". This takes some planning. For example, an assessment sheet that is a set of checks in boxes rather than a blank form for you to write paragraphs saves alot of time. Having effective corrective strategy protocols for common dysfunctions allows you to implement a strategy immediately. Most important, is that you are good at creating instant change, which takes practice. I am writing on this topic in the "Fitness Executives" linkedin group. If your interested, check it out.
Blake Robinson, May 2 at 1:11pm: FMS to identify any musculoskeletal imbalances, Bruce Treadmill test to assess cardiovascular health (unless high risk client), Readiness for Change questionnaire to asses mental state, environmental support, and social support, PAR Q, and I take a look at their goals to make sure that they meet the SMART qualifications….hey that might look familiar to any of my other Equinox friends but why change something if it ain't broken?
Brent Brookbush, May 2 at 1:17pm: Hey Blake, That is a great and thorough assessment that I am very familiar with (I was faculty for Equinox - EFTI from 2006-2009). I do have one issue however… What is the strategy that you implement to correct the dysfunctions noted in the FMS assessment. To me this was a gap that we had a hard time filling… Just curious… how much change have you noted from initial assessment to reassessment, and do you think this had created a value add, or set you up for an awkward situation?
Blake Robinson, May 2 at 1:22pm: The FMS is my basis for what exercises I choose for each client, it does take more time to make a program because i always have to go back, look at what exercises I am asking a client to perform and check myself, "Is this correcting the problem or making it worse?" Many times I'll write a program 2-3 times before I feel it's right. The best way I've been able to get clients to change is to emphasis the fact that at most they are spending 3-5 hours fixing what they are making worse the rest of the day so that it sticks in the back of their mind at all times. Creating a micro-correction program involving the necessary stretches and exercises that takes 5-10mins each day has shown dramatic improvements…BUT…it does take time and follow up for the client to do it on their own. Sure you can create the world’s greatest program and have the most dedicated client but when they are not in the gym with you they aren't thinking about their misaligned shoulders so I send clients quick texts during the day to remind them to keep shoulders relaxed and back by their ears. Some clients really appreciate it, others not so much but the ones that do the micro-correction exercises daily see the best results…funny how that works.
Blake Robinson, May 2 at 1:24pm: To sum all that up, I try to help clients realize that their goals are normally too short sited, this is life, your health and standard of living depends on them making healthy choices and a concerted effort the rest of their lives…what's the point of working you’re a$$ of for 6 months to see it all go down the drain?
Mikal Payne, May 2 at 1:25pm: Those are fabulous ideas, I see if can get Hakem and Joel on board and see if we can get something going.
Brent Brookbush Great stuff Blake. I love all the attention your paying to correcting dysfunction, optimal exercise selection, and of course consistent reinforcement. I do think that some form of static release (foam roll, med. ball, etc.) work needs to be added to that program, but that in no way takes away from the commendable job your doing. Thank you for sharing.
Blake Robinson, May 2 at 1:27pm: The FMS gives you street cred., as soon as I tell a client why they went through it and start explaining the ramifications of having misaligned hips, shoulders, imbalances left to right and how much better their lives will be if they fix it, BAM! no more need to sell your services they know you understand the body, they can see the benefit, and they understand that they will be working with you for months if not the rest of their lives.
Blake Robinson, May 2 at 1:28pm: Favorite tool lately is the spikey ball from perform better.com and have been helping clients fix crappy hips and shoulders…that's it i'll shut up now.
Brent Brookbush, May 2 at 1:39pm: My issue with the FMS in paticular is not on what it gives you as far as credibility, but what it fails to provide in terms of a solution. The assessment is fine, but if you do not have knowledge beyond what that program provides you, good luck optimizing mechanics and improving performance during reassessment. It sounds like you really do your homework Blake, but can we expect that out of every trainer. If you roll it out as a company initiative of course there will be a short term upspike in sales and perception of value, but what happens in the long-term when reassessment points out a weakness?
Blake Robinson, May 2 at 1:51pm: As much as we like to think we know everything about a client's body after our initial assessment not until it has been tested and proven will we truly understand all imbalances and weaknesses that exist. As a trainer we have to constantly be paying attention, be evaluating a client's motion through space, too many times we start working with a client and we stop once they reach the "good enough point" we figure it's not going to harm them…that's when mistakes are made, weaknesses are encouraged, and our clients regress. The trainer is in charge of a client's progress and all responsibility/liability rest on his/her shoulders so if we want our clients goals to be "good enough" that's all it will ever be. It can be frustrating to see new weaknesses when our program was spot on but it's just another challenge to overcome, ignore it and perish. It may be the clients fault either by admission or omission or it may be the trainers fault admission/omission either way be the professional make the changes address the issues and moves forward with positivity. The correction may simply be made through better verbal cues, adjusting resistance (bands, dbs, body wgt) or by adjusting the plane of motion. A trainer can never stop learning and any pt manager must always be a second set of eyes to provide support and feedback for his/her team. If reassessment points out a weakness redo the FMS, scrap your previous program restart, yes it sucks, yes it's time consuming, but it's part of the job and if you let something slide due to laziness and a client is injured it's the trainer's a$$ that's on the line.
Brent Brookbush, May 2 at 5:00pm: Those are great points, it is often through trial and error we come to optimal programming. I think most important is to remember there is more thorough assessment to be had, and better techniques and corrective programming to learn. If we do have certain short-comings in our program I think we need to use this as a cue to continue studying, as well as, continue working through issues with our clients. When you consider the amount of tools that are out there, and the success of some of the elite in our industry it is obvious there is more. Even Lee Burton of FMS admitted to using release and static stretching to optimize his FMS based corrective strategies. The NASM CES model is more complete using release, and stretching as part of the model, but even Mike Clark of NASM uses manual relase techniques and mobilizations in his own practice to optimize the CES model with his clients. I do disagree that better cueing is ever the answer alone… Corrective modalities are neccesary. For example, if a person has adaptive shotening of the gastroc/soleus complex, and a decrease in dorsiflexion ROM causing his feet to turn out, all the cueing in the world is not going to change this. If you manage to keep their feet straight they will only compensate somewhere else (example, excessive forward lean). This concept known as "Relative Flexibility" is well noted in Shirley A Sahrmann's - Movement Impairment Syndrome. It is one of the reasons why a set of exercises, no matter how brilliant will not correct compensations without release and stretching first.
Blake Robinson, LOVE IT!!!