Despite the availability of the Physical Activity Guidelines, health disparities among adults with disabilities continue to increase. The purpose of this ACSM brochure is to highlight meaningful health facts and activity barriers facing adults with disabilities. Several strategies and ideas to overcome these barriers are recommended.

What Do We Know About Adults with Disabilities and Their Physical Activity Participation?

• One in five adults or over 53 million people in the United States have a disability 
• 34% of adults with disabilities report 14 or more physically unhealthy days in the past 30 days compared to only 5% for adults without disabilities 
• Obesity rates for adults with disabilities are 58% higher than for adults without disabilities 
• 38% of adults with disabilities report participating in sufficient aerobic physical activity compared to 54% of adults without disabilities 
• Only 14% of adults with disabilities meet both aerobic and muscle strengthening guidelines for good health compared to 23% of adults without disabilities 

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5 key concepts for cueing your clients, to help them get the results they deserve.

Key Points:

1. Make being a great communicator a focus to being a great coach.

2. Make cues for movement “sticky” and meaningful.

3. Shut-up, too much verbal cueing is detrimental.

 

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Helping our clients achieve their best movement is, or better be, the most important and challenging task we have as fitness professionals.  Clients all have different movement abilities as well as communication skills and life lessons that all play a role in how well they “get it” when it comes to establishing sound movement ability.  Following some key concepts of how to communicate what you want to see in your client’s movement will lead to the results they are searching for.

Getting the best movement out of our clients is, or better be, the most important and challenging tasks we have as fitness professionals.

 

In my experience, the best developed program with all the bells and whistles means very little if you can’t communicate it to your client to deliver the results they are looking for and you ultimately promised to provide.  Elaborately designed spreadsheets and program templates with the most up to date exercises will not deliver the goods unless you can.  Your ability to communicate and cue the movement you are after will be the difference, not your workout template.  Spend time becoming a great communicator of your program with strong cueing and delivery.  This article will cover the five keys that I have found to be the most powerful to cueing proper movement.

In my experience, the best developed program with all the bells and whistles means very little if you can’t communicate it to your client to deliver the results they are looking for and you ultimately promised to provide.

 

1. Attack one thing at a time

When it comes to technique, prioritize what’s most important at the time and focus on making that better.  Many times, correcting that one thing leads to the client understanding and attaining the skill or exercise.  Grab the lowest hanging fruit first and work one thing at a time.

 

2. Use short and “sticky” cues

Keep each cue short, easy to understand and that has meaning to the client.  The cue should “stick” after establishing meaning and using it during the movement.  One of my favorites is “tuck the tail” when coaching a posterior pelvic tilt to provide a more neutral spine during a movement.  I don’t have to do a whole of explaining of what the means and I get what I am after and the next time I use that cue they will know exactly what I am looking for -- it’s sticky.

3. Avoid too much technique talk

Even if the technical breakdown of a particular movement is correct, most of the information is meaningless to the client.  You will be just clogging up the airways with terms and concepts that will get in the way of the client mastering the movement.  Phrases like “extend to hip,” “squeeze your glutes” and “externally rotate your shoulder” will be a foreign language to most clients, causing a great deal of confusion.

4. External cueing is king

Use the environment and a client’s natural reflexes to help them understand a movement concept or body position.  These external cues are so much more meaningful to the client, using fewer words than internal cues making them so much more effective.  If I want a client to keep their chest up during a squat I will say “zip up your coat” or “proud chest”; or I can have them face a wall and they can’t touch it with any part of their body during the squat.  Easy to understand with very little talking.

5. Shut up

Use as few cues as possible to get the movement you are after.  Too much verbal coaching can overwhelm and confuse your client, leading to some big-time frustration if they can’t master the movement.  Establish more meaning during rest periods, but continue to keep it short, to the point, and understandable.  It’s OK for them to “feel the wrong” as it will allow for better learning, but don’t bombard them with words when they are trying to move.

Take Home:
Your ability to communicate as a coach will determine how successful your clients will be.  Sharpen that skill, and you will be more successful as a coach and provide so much more to your client.

Ready to learn more? Watch the full session from Tony Maloney and Becky Langton and earn 3 CECs!

Coach It Up! Coaching and Cueing Proper Movement


Author: 
Tony Maloney ACSM-EP
Since coming to NIFS in 2008 Tony has worked with hundreds of clients of different fitness levels to achieve both fitness and lifestyle outcomes.Speaking to large corporate groups as well as to his large membership base is an opportunity Tony loves to take on and has presented to countless individuals ranging from College students, corporate leaders, members and fellow fitness professionals.Tony has been the Fitness Center Manager for 8 of his 11 years with NIFS and enjoys leading his team to provide the best experience for all the members at NIFS.

 

Your internship experience is where the rubber meets the road, and your career gets started. Here are 5 tips to make the most of it.

Key Points:

1. Anticipate that this will be the best learning experience ever.

2. Be professional, treat the internship like a job (or a really long job interview).

3. Don’t overestimate what you can do.

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Internships are like anything else in that what you get back is directly proportional to what you put in. You can go through the motions, counting the days until the internship ends or you can immerse yourself in the experience and go on to become a leader in the profession. 

As part of the team in the Preventive Cardiology Department at Henry Ford Hospital in Detroit Michigan, we’ve found that best way to elevate the profession of clinical exercise physiology is to be heavily invested in the education of not only the current generation of providers, but the next one as well.  Preventive Cardiology department internships are 16 weeks long, and typically there are four interns per cycle. Students are exposed to adult weight management, cardiopulmonary stress testing, early outpatient cardiac rehabilitation (Phase 2), cardiac rehabilitation maintenance (Phase 3), pulmonary rehabilitation, and directed research.

 

Your internship experience is meant to be the culmination of your degree program, the place where academic preparation meets clinical practice. It’s where the rubber meets the road, and your career gets started.

 

The following is gleaned from decades of experience providing clinical internships and is meant to help students get the most out of their experience.

1. Anticipate that this will be the best learning experience ever.

   Your clinical internship can (and should) have a profound effect on your career path and future job satisfaction. Look for sites that can provide you with a wide variety of experiences, not just one like cardiac rehabilitation, or diabetes management. Don’t hesitate to ask for additional experiences – observing in the cardiac catheterization lab, visiting another rehabilitation site, shadowing a physician’s assistant or physician. This is your time to find out what interests you so make the most of it.

    

2. Be professional - treat the internship like a job (or a really long job interview).

   Be on time. Always. Dress appropriately. Interact with patients with respect and dignity. Complete assigned tasks without being asked twice. You may not get a job offer from your internship site as they may not have a position to offer you, but a letter of recommendation from an established professional in your field who’s had an opportunity to observe you for several hundred hours can go a long way towards landing that coveted first job.

    

3. Ask questions. Ask a lot of questions.

   No one expects interns to know everything. Be intellectually honest about what you know and what you don’t. Ask questions about clinical items you don’t fully understand. Keep asking until you do understand – there truly is no such thing as a stupid question. Don’t restrict your questions to clinical subjects either, ask the staff why they do this job, what they like about it and what they don’t. Never again in your career are you likely to be surrounded by experienced professionals so invested in your education. Maximize this opportunity.

    

4. Take notes and study.

   Your internship experience may be your first foray into a clinical setting and a lot of things may come up that are unfamiliar. Take notes whenever possible and study during off hours. This will help you learn faster and formulate your questions to staff so that you’re getting the most out of the experience. Staff takes notice when interns present interesting or challenging questions.

    

5. Don’t overestimate what you can do.

Your internship experience will likely be an intense learning experience. You want to make sure that you’re physically and mentally prepared to get the most out of it. If possible, try not to have another job during your internship. If you do have to work during your internship, try to reduce your hours or work weekends so you can maintain your focus.

Your internship experience is meant to be the culmination of your degree program, the place where academic preparation meets clinical practice. It’s where the rubber meets the road, and your career gets started. You don’t need to research potential internship sites with quite the same intensity as you did your academic program (though it wouldn’t hurt), but you should approach your internship with the energy and enthusiasm befitting the transition from student to professional. This is your time, make the most of it.

Author: 
Robert Berry is a Master’s prepared Clinical Exercise Physiologist with 18 years’ experience in cardiac rehabilitation and holds the ACSM-CEP and is a registered RCEP. He is currently employed as the Clinical Coordinator of Cardiac Rehabilitation at Henry Ford Hospital in Detroit, MI. Robert has been active on ACSM’s Clinical Exercise Physiology sub-committee and the ACSM Exam Development Team. Additionally, Robert is a past President of the Clinical Exercise Physiology Association.

 

About the course:

This course includes an online ACSM Partner webinar and a corresponding online quiz. All course content will be presented to you electronically upon completion of your purchase. This includes all webinar videos, quizzes, and certificates (certificates awarded upon successful completion of the quizzes).

Available ACSM CECs 2.0

Learning Objectives for the CEPA Muscling Up on Mental Illness course:

• Appreciate the need and opportunities for clinical exercise services in the treatment of a range of mental health disorders including major depressive disorder, schizophrenia, bipolar disorder and posttraumatic stress disorder.
• Understand the dual role exercise interventions can play in improving both mental and physical health outcomes.
• Understand the most recent evidence regarding the impact of exercise on mental disorders and opportunities and implications for future translational research.
• Recognize appropriate evidence-based exercise assessments, components of intervention delivery, program design and examples of referral pathways, including special considerations and potential contraindications to exercise prescription in this population.

Purchase and earn CECs

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Each May ACSM celebrates Exercise is Medicine Month by uniting to advocate for the integration of physical activity within clinical care, connecting patients and providers with evidence-based fitness resources. 

To celebrate, we've compiled some of our most popular videos, presented in this triple feature.

Exercise is Medicine | What is the EIM Solution?

Exercise is Medicine: The Importance of Connecting Fitness with Healthcare

Is Exercise Really Medicine?

For more information, visit exerciseismedicine.org