Exercise certification provides a measure of competence for ---

By Benjamin Taylor,2014-08-09 03:57
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Exercise certification provides a measure of competence for ---

Draft-Exercise Leader Certification MT/WY Tribal Leaders Council

    “Exercise Certification Programs for Tribal Staff: Choosing the Right Program for Your Needs”

Rob Schurrer, PhD


    Black Hills State University

    Spearfish, SD 57799-9405

    TEL 605-642-6169

    This paper was prepared for the TLC with funding from Agency for Healthcare Research and Quality Grant # 1 R24 HS14034-01.

Background and Purpose

    Discussions with Tribal Health Directors and staff members over the past year have generated considerable interest in Exercise Certification. The purpose of this paper is to provide information about the many certification options available to the Tribal Health Directors and aid them in choosing the best/appropriate training and certification programs for their staff.

Overview of Exercise Certification Issues

    Exercise certification provides a measure of competence for professionals and employers in the area health and physical fitness. It has been estimated that over 300 certification options are available worldwide. A problem with numerous certifications is that is a wide variance in the requirements for certification exists. Since a license is not required to claim one is an Exercise Leader or Exercise Specialist, certifying agencies can be established by anyone with a typewriter or computer and printer. Many certifying organizations will offer to come into your facility or community and teach a one-day certification course with an exam at the end of the workshop. This provides certification,


Draft-Exercise Leader Certification MT/WY Tribal Leaders Council

    but does not provide client, patient, or facility with the knowledge that exercise supervision is medically and scientifically sound, and safe for all concerned.

    When you decide to become certified you should seek out an organization that is respected by the professionals in the area of study, and one that has standards that must be met. Most exercise leader or personal trainer certifications use the American College of Sports Medicine (ACSM) as a guide. ACSM has been certifying exercise professionals since 1975, and is the leader in exercise research.

     Certifications require knowledge and skills in the areas of anatomy, physiology, exercise physiology, nutrition, kinesiology, biomechanics, health-related physical fitness assessment and exercise programming. The degree to which a person masters these areas determines the level of certification.

    Academic programs at colleges and universities can be difficult to understand, particularly in the health-related physical fitness and health promotion areas. A recent study by Elder et al. examined 235 undergraduate Exercise Science programs and found that 29% followed ACSM guidelines and 33% followed ACSM and National Association for Sport and Physical Education (NASPE). While adherence to the areas of exercise physiology, biomechanics, and human anatomy and physiology were good, very little attention was paid to exercise prescription, exercise testing, exercise and aging, or exercise with special populations. Most programs also did not require an internship or field experience and place minimal attention to health promotion. It is imperative that the staff or perspective student examines the curriculum before enrolling in a local college or university that declares their major as Exercise Science.


Draft-Exercise Leader Certification MT/WY Tribal Leaders Council

    The focus of this paper will be to describe several certification options in the area of health-related fitness. These certifications place a special emphasis on rehabilitation from or reducing the risk of lifestyle disease such as cardiovascular disease, diabetes, obesity, and hypertension. Exercise and physical activity as a safe treatment option is the hallmark of these certifications

    What follows in this paper is an explanation of accreditation, levels of certification available and the general requirements, recommendations, certifying agencies endorsed by NOCA, and certifying agencies not endorsed by NOCA. None of these certification options are free, so we need to pay attention to what is the best fit for staff education and safe supervision of the participants enrolled in our programs.

NOCA and the National Commission for Certifying Agencies

    Established in 1977, the National Organization for Competency Assurance (NOCA) is the leader in setting quality standards for credentialing organizations. Through its annual conference, regional seminars, and publications, NOCA serves its membership as a clearinghouse for information on the latest trends and issues of concern to practitioners and organizations focused on certification, licensure, and human resource development. The National Commission for Certifying Agencies (NCCA) is the accreditation body of NOCA. Certification programs may apply and be accredited by the NCCA if they demonstrate compliance with each accreditation standard. NCCA's Standards exceed the requirements set forth by the American

    Psychological Association and the U.S. Equal Employment Opportunity Commission.


Draft-Exercise Leader Certification MT/WY Tribal Leaders Council

    An NCCA accredited certification program must:

    Conduct certification activities in a manner that upholds standards for competent practice in a profession, occupation, role, or skill.

    Include individuals from the certified population on the certification board or governing committee of the certification program.

    Establish, publish, apply, and periodically review key certification policies and procedures concerning existing and prospective certificants.

    Employ assessment instruments that are derived from the job/practice analysis and that are consistent with generally accepted psychometric principles. Develop and adhere to appropriate, standardized, and secure procedures for the development and administration of the assessment instruments.

    Set the cut score consistent with the purpose of the credential and the established standard of competence for the profession, occupation, role, or skill. Award certification only after the knowledge and/or skill of individual applicants have been evaluated and determined to be acceptable.

    Establish and apply policies and procedures for secure retention of assessment results and scores of all candidates.

    Demonstrate that its recertification requirements measure or enhance the continued competence of certificants.

    A complete listing of the requirements can be found at A list of the members and disciplines

    covered by NCCA is listed at:

    As you can see, NCCA is a non-profit, non-governmental organization that sets the benchmark for how organizations should conduct certifications. The disciplines covered include physical fitness, medicine, nursing, nutrition, occupational therapy, emergency medical response, athletic training, and psychology.

    A best practice has not been established for exercise certification since the needs of the professional and agency vary, and one certification does not meet the needs of all people seeking advice and consultation regarding their personal exercise training.


Draft-Exercise Leader Certification MT/WY Tribal Leaders Council

    Entry Level

    Entry-level certifications typically require the person to be over the age of 18, have CPR certification, and a basic knowledge of exercise physiology and anatomy. The largest percentage of certifications is available at the entry level. These entry-level certifications typically do not require formal education or coursework from an accredited college or university, and often are supplied by for profit organizations. An example of a certification that has standards and an organization to support continuing education and training is the Personal Trainer certification from the American Council on Exercise

    (ACE) ACE’s Personal Trainer certification is an entry-level

    certification designed for trainers providing any form of one-on-one instruction, or in small groups. According to ACE, special attention has been given to injury prevention, emergency techniques and legal issues confronting today’s fitness professionals. This certification exam requires a person to demonstrate their basic knowledge of exercise science, nutrition, fitness assessment, exercise programming, and instructional and spotting techniques. An Associates or Bachelors degree from an accredited college or university is not required, however the person seeking certification must be CPR certification and have the knowledge to pass the exam. Study materials and workshops are available from ACE to prepare for this exam. This certification can be obtained with 150-300 hours of self-study depending on the academic background of the person seeking certification. I believe an entry level certification of this nature can be achieved with approximately 9 credit hours of course work in the respective areas with a focus on achieving minimal competency in the area of exercise leadership.


Draft-Exercise Leader Certification MT/WY Tribal Leaders Council

    Second Level

    Health Fitness Instructor (HFI) certification from the American College of Sports

    Medicine is available for anyone with an Associates or Bachelors degree in a health related discipline and certification in CPR. The ACSM Health/Fitness Instructor? (HFI) is a professional qualified to assess, design, and implement individual and group exercise and fitness programs for apparently healthy individuals and individuals with controlled disease. The HFI is skilled in evaluating health behaviors and risk factors, conducting fitness assessments, writing appropriate exercise prescriptions, and motivating individuals to modify negative health habits and maintain positive lifestyle behaviors for health promotion. In most fitness settings, the Health Fitness Instructor works under the direction of an Exercise Specialist or Clinical Exercise Physiologist. Most of the people seeking this certification have completed a Bachelors degree, although a well-designed associates program can properly prepare students for this exam. Twenty to thirty hours of college coursework (1 credit hour usually involves 15 hours of class) in anatomy, physiology, exercise physiology, nutrition, health-related fitness assessment, kinesiology, first aid/CPR, and exercise programming are required for successful completion of this certification exam. Most hospital based Cardiac Rehabilitation programs that employ exercise leaders that have the HFI certification, or ask that they attain this certification within a few months.

Third Level

    The Exercise Specialist? is a healthcare professional certified by the ACSM to

    deliver a variety of exercise assessment, training, rehabilitation, risk factor identification


Draft-Exercise Leader Certification MT/WY Tribal Leaders Council

    and lifestyle management services to individuals with or at risk for cardiovascular, pulmonary, and metabolic disease(s). These services are typically delivered in cardiovascular/pulmonary rehabilitation programs, physicians’ offices or medical fitness

    centers. The ACSM Exercise Specialist? is also competent to provide exercise-related consulting for research, public health, and other clinical and non-clinical services and programs. The majority of people seeking this certification have

    completed graduate degrees in exercise physiology, health promotion, cardiopulmonary rehabilitation, occupational or physical therapy. This level of mastery requires hundreds of hours of clinical experience and knowledge of pharmacology, clinical exercise physiology, advanced physical fitness assessment, and advanced exercise prescription. Individuals with a Bachelors degree that seek this certification typically are working in cardiac rehabilitation and have thousands of hours of clinical experience.

Fourth Level

    The highest level sought by professionals in Health-Related fitness is either the Program Director, or Clinical Exercise Physiologist certification from the ACSM. These professionals have usually completed PhDs in Exercise Physiology and are working in clinical settings as clinical directors, or directing research.

    The wide range of certifications for exercise professionals can be very confusing. Many certifications can be obtained by attending a daylong workshop that covers anatomy, physiology, nutrition, kinesiology, exercise physiology and exercise programming immediately followed by an exam. While review courses for rigorous certifications may last for 1-2 days, the level of competency is quite low for the entry-


Draft-Exercise Leader Certification MT/WY Tribal Leaders Council

    level certifications that teach and test on the same day. The safety and health of all concerned depends on exercise leaders mastering their field of study.

Cost of Certification

    The cost of attaining and maintaining certification can be over two hundred dollars annually. This expense includes annual membership fees, and the cost of continuing education. Fortunately the respected and rigorous certifications require continuing education to maintain certification. This can be achieved at our remote sites through journals and regular notices from the organizations.

     The American Council on Exercise (ACE) has $200.00 fee

    for the Personal Trainer Exam, and requires 15-20 hours of approved continuing education every two years. ACSM has annual dues of $190.00 and a four-year time frame for recertification Requiring a

    $60.00 fee for recertification.


    Exercise certification of any degree is worthwhile and beneficial to the professional, the facility, the program and most of all the client or participant. I have given three or four options requiring a varied educational background and experience. The question that often comes up is “Why don’t we develop our own certification program”? My response is why spend the time and effort to do this when viable appropriate programs already exist. The other added benefit is that using outside certifying agencies gives your staff and program legitimacy. The certification options


Draft-Exercise Leader Certification MT/WY Tribal Leaders Council

    and organizations (ACE and ACSM) support their programs with rigorous review and valid testing. It is much more cost effective if the money is spent on staff education and training to achieve the certifications that are already recognized by the nationally recognized organization who certify testing programs.

    Continuing education is vital to the effectiveness of a health-related physical fitness program. Exercise is an essential treatment modality when working with diabetes, cardiovascular disease, obesity and hypertension. To afford participants maximal benefit from their exercise program the exercise leader must know what is appropriate, and what is a “best practice.” The professional certification programs seek and support this goal. Professional exercise leaders and trainers must constantly review the latest scientific literature and expand their knowledge of ways to improve their client or patients exercise training. Entry-level certifications such as the ACE Personal Trainer certification program is an excellent starting point for staff education, and certification.

    Many of the problems associated with exercise training can be avoided or prevented if the exercise specialist or leader knows how the patient will respond to various modes of exercise. The goal of exercise training is to enhance the functional capacity of the individual, and in doing this we usually observe a decreased risk for lifestyle disease such as cardiovascular disease, cancer, diabetes and stroke. Since all people are neither capable of nor interested in the same exercise program, a competent skilled exercise specialist can adapt the exercise-training program to best fit the needs of the individual.


Draft-Exercise Leader Certification MT/WY Tribal Leaders Council

    After achieving the knowledge base that would allow an exercise specialist to pass the ACE Personal Trainer exam, the next step would be to prepare for the ACSM Health Fitness Instructor certification. This is a natural progression as the knowledge, skills and abilities required for this exam ask the fitness professional to take more of a leadership role. It is very common for exercise specialist who holds the Health Fitness Instructor certification to play a role in the continuing education of the client or patient. The addition of these educational classes for the participants is very beneficial in terms of exercise compliance, and adherence to positive health behaviors, both of which will improve the quality of life for the participant.

NOCA Approved Credentialing Organizations

    The American Council on Exercise (ACE) is a nonprofit organization dedicated

    to promoting the benefits of physical activity and to protect the public against unqualified fitness professionals and unsafe or ineffective fitness products, programs and trends. Founded in 1985, the organization has grown significantly and states that they have certified over 200,000 professionals worldwide. ACE is one of two organizations recognized by NOCA in the area of physical fitness. (The National Strength and Conditioning Association is the other specializing in sports related training.)

    ACE offers several certifications requiring a variety of educational preparation. The ACE Personal Trainer Certification is designed for trainers providing any form of one-on-one instruction, demonstrating a basic knowledge of basic exercise science, nutrition, fitness assessment, exercise programming, and instructional and spotting techniques.


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