According to the Register of Exercise Professionals South Africa (REPSSA) the following scope of practice applies to exercise professionals in South Africa:
1. Fitness Instructor:
An exercise professional / fitness practitioner responsible for orientating members into an exercise setting; able to induct members and supervise members exercise sessions from a pre‐designed exercise programme
Competency and scope of practice:
A. Plan and Instruct Classes:
1. Apply basic knowledge of anatomy and physiology, according to exercise modality
2. Lead exercise session according to pre‐designed plan and/or club timetable
3. Provide safe and effective warm up and cool down
4. Regress and progress exercises and sessions
5. Select appropriate pre‐designed exercise programmes in accordance with client’s abilities, needs and goals
B. Leadership and Communication:
1. Instruct exercise with the use of effective motivation and leadership skills
2. Lead and instruct exercise with the use of effective visual and verbal communication skills
3. Conduct oneself in a confident and professional manner
C. Risk Screening:
1. Conduct basic risk screening with PAR‐Q process
2. Interpret a PAR‐Q
D. Health & Safety:
1. Provide safe and effective exercises according to exercise modality
2. Ensure health & safety of the exercise environment
3. Manage self and members in a fitness facility environment
4. Maintain the fitness environment and equipment according to safety requirements
Outside scope of practice
• Personalised exercise programmes and/or one‐on‐one personal training
• Assessment and fitness testing
• Rehabilitation programmes
• Exercise for Special populations
• Providing nutritional advice/guidelines
2. Personal Trainer
An exercise professional /fitness practitioner qualified to provide advice and a range
of exercise training programmes to apparently‐healthy populations.
Professional scope of practice includes: pre‐participation risk screening, assessment
and sub‐maximal fitness testing, evaluation of clients’ needs and goals, exercise
programme design and instructing safe and effective exercise sessions.
Competency and scope of practice
A. Plan and instruct classes/exercise sessions:
1. Apply knowledge of anatomy and biomechanics to exercise programmes and training sessions
2. Apply knowledge of physiology to exercise programmes and training sessions
4. Provide safe and effective warm up and cool down
5. Regress and progress exercises and sessions
6. Design exercise programmes based on clients’ needs, abilities and goals
7. Plan exercise sessions based on clients’ abilities, needs and goals
B. Leadership and communication
1. Instruct exercise with the use of effective motivation and leadership skills
2. Lead and instruct exercise with the use of effective visual and verbal communication skills
3. Motivate clients through agreed exercise session/s
4. Conduct oneself in a confident and professional manner
C. Risk screening, assessment and fitness testing:
1. Conduct client screening and assessment
2. Interpret a PAR‐Q
3. Conduct health evaluation and postural assessment
4. Conduct sub maximal fitness testing
5. Identify clients who are outside scope of practice and refer appropriately
6. Work only with apparently‐healthy clients, within scope of practice
7. Provide generic nutritional guidelines
E. Health & Safety:
1. Provide safe and effective exercises according to exercise modality
2. Ensure health & safety of the exercise environment
3. Manage self and clients in a fitness facility environment
4. Maintain own fitness environment and equipment according to safety requirements
5. Ensure injury prevention measures
F. Business management and administration:
1. Manage a fitness business in compliance with legislative requirements
2. Maintain confidentiality of clients’ records
3. Ensure systematic records management
Outside scope of practice
• Working with special populations; pregnant clients, children and adolescents and/or clients who fall within moderate and high risk factors based on ACSM guidelines.)
• Working with or designing programmes for athletic conditioning
• Working in rehabilitation, providing therapeutic exercises and providing exercise for the correction
• of faulty motor patterns
• Working with acutely injured clients or members
• Working with clients that experience chronic pain
• Prescribing dietary intervention and supplementation
3. Exercise Specialist
An exercise professional /fitness practitioner qualified to provide advice and a range of exercise training to apparently‐healthy populations including special populations defined as pregnant clients, children and youth and/or older adults that have been cleared for exercise.
Professional scope of practice includes: pre‐participation risk screening, assessment and fitness testing, evaluation of clients’ needs and goals, exercise programme design and instructing safe and effective exercise sessions.
Competency and scope of practice:
MINIMUM PRE‐REQUISITE: CERTIFICATE PERSONAL TRAINING
A. Plan and instruct classes/exercise sessions:
1. Apply knowledge of anatomy and biomechanics to exercise programmes and
training sessions
2. Apply knowledge of physiology to exercise programmes and training sessions
3. Lead exercise session according to designed plan
4. Provide safe and effective warm up and cool down
5. Regress and progress exercises and sessions
6. Design exercise programmes based on clients’ needs, abilities and goals
7. Plan exercise sessions based on clients’ abilities, needs and goals
B. Leadership and Communication:
1. Instruct exercise with the use of effective motivation and leadership skills
2. Lead and instruct exercise with the use of effective visual and verbal communication
Skills
3. Motivate clients through agreed exercise session/s
4. Conduct oneself in a confident and professional manner
C. Risk Screening, assessment and fitness testing:
1. Conduct client screening and assessment
2. Interpret a PAR‐Q
3. Conduct health assessment and postural assessment
4. Conduct fitness testing, according to needs and ability of client
5. Identify clients who are outside scope of practice and refer appropriately
6. Work only with apparently‐healthy clients and special populations, within scope of practice
7. Provide generic nutritional guidelines
D. Health & Safety:
1. Provide safe and effective exercises according to exercise modality
2. Ensure health & safety of the exercise environment
3. Manage self and clients in a fitness facility environment
4. Maintain own fitness environment and equipment according to safety requirements
5. Ensure injury prevention measures
OUTSIDE SCOPE OF PRACTICE
• Working in rehabilitation, providing therapeutic exercises and providing exercise for the correction of faulty motor patterns
• Working with acutely injured clients or members
• Prescribing dietary intervention and supplementation
• Working with clients that experience chronic pain
4. Sports Conditioning Coach
An exercise professional /fitness practitioner qualified to provide advice and a range of exercise training to apparently‐healthy populations who require programmes for athletic conditioning.
Professional scope of practice includes: pre‐participation risk screening, assessment and fitness testing, evaluation of clients’ needs and goals, exercise programme design and instructing safe and effective exercise sessions.
Competency and scope of practice:
MINIMUM PRE‐REQUISITE: CERTIFICATE PERSONAL TRAINING
A. Plan and instruct classes/exercise sessions:
1. Apply knowledge of anatomy and biomechanics to exercise programmes and
training sessions
2. Apply knowledge of physiology to exercise programmes and training sessions
3. Lead exercise session according to designed plan
4. Provide safe and effective warm up and cool down
5. Regress and progress exercises and sessions
6. Design exercise programmes based on clients’ needs, abilities and goals
7. Plan exercise sessions based on clients’ abilities, needs and goals
B. Leadership and Communication:
1. Instruct exercise with the use of effective motivation and leadership skills
2. Lead and instruct exercise with the use of effective visual and verbal communication
skills
3. Motivate clients through agreed exercise session/s
4. Conduct oneself in a confident and professional manner
C. Risk Screening, assessment and fitness testing:
1. Conduct client screening and assessment
2. Interpret a PAR‐Q
3. Conduct health assessment and postural assessment
4. Conduct fitness testing, according to needs and ability of client
5. Identify clients who are outside scope of practice and refer appropriately
6. Work only with apparently‐healthy clients and special populations, within scope of practice
7. Provide generic nutritional guidelines
D. Health & Safety:
1. Provide safe and effective exercises according to exercise modality
2. Ensure health & safety of the exercise environment
3. Manage self and clients in a fitness facility environment
4. Maintain own fitness environment and equipment according to safety requirements
5. Ensure injury prevention measures
OUTSIDE SCOPE OF PRACTICE
• Working in rehabilitation, providing therapeutic exercises and providing exercise for the
• correction of faulty motor patterns
• Working with acutely injured clients or members
• Prescribing dietary intervention and supplementation
• Working with clients that experience chronic pain
Medical Professionals
Within a health and fitness facility, a fitness professional may also work closely with the following health professionals. The scope of practice for each professional will be according the Health Professions Association of South Africa (HPCSA) and/or the relevant medical board.
1. Biokineticist
“Biokinetics” means the profession concerned with preventive health care, the maintenance of physical abilities and final phase rehabilitation, by means of scientifically-based physical activity programmes;
• “scientifically-based physical activity programmes” means specific and individual-oriented physical training programmes based on the individual’s physical condition and compiled and supervised;
• “final phase rehabilitation” means the period or phase in the rehabilitation process in which physical activity and physical conditioning constitute the primary therapeutic modality;
Scope of a Biokineticist
(1) Promotion of physical abilities, prevention of certain ailments, and physical selection:
(a) Recording of general history with a view to determining the risks of exercise (if any) for the individual.
(b) Evaluation: Physical work capacity test: Determination of physical work capacity with the aid of a cycle ergometer or treadmill, monitoring equipment and available associated equipment to arrive at and determine an effective and safe exercise level for an exercise programme prescription using the following tests:
(i) Monitoring of heart rate with an electrocardiograph or heart rate monitor during multistage workloads.
(ii) Measurements of blood pressure and other physiological responses before, during and after work.
(iii) Measurement of range of motion and muscle strength.
(iv) Evaluation of body posture and body composition.
(c) Exercise programme prescription: Prescription, follow-up of and guidance of specific exercise programmes.
(d) Physical selection: Evaluation of and exercise programme prescription for special groups and professions.
(2) Final phase rehabilitation: Musculoskeletal system:
(a) Functional ergological assessment: The assessment of the affected limb or body part to determine the functional limitations with the aid of the following:
(i) Specific history of the condition and previous treatment, and a general medical history.
(ii) Specific assessment of the affected limb or body part. This includes the manual determination of:
– range of motion;
– muscle strength; and
– flexibility.
(iii) Analysis of posture.
(iv) Specialised tests for muscle strength, muscle exhaustion and range of motion of joints by means of the assessment of torque, muscle, work, ratios between antagonistic muscle groups with regard to torque and work, bilateral comparisons with regard to torque and work, range of motion and extent and position of restriction resulting from injury or deviation.
(b) Rehabilitation programme prescription: Orthopaedic final phase rehabilitation programme prescription. Taking the patient through rehabilitation programme prescription.
(c) Rehabilitation session: Orthopaedic final phase rehabilitation session.
(d) Rehabilitation session on specialised equipment: Final phase rehabilitation with the aid of electronic-hydraulic isokinetic systems.
(3) Final phase rehabilitation: Medical conditions:
(a) Functional assessment:
(i) General history with a view to determining the risks of exercise for the patient.
(ii) Physical work capacity test: The determination of physical work capacity with the aid of a cycle ergometer or treadmill, monitor equipment and available associated equipment to determine an effective and safe final phase rehabilitation programme prescription using the following tests:
(b) Rehabilitation programme prescription: Final phase rehabilitation programme prescription for specific medical conditions.
2. Physiotherapist
Physiotherapy is concerned with:
• Assessing, treating and preventing human movement disorders, restoring normal function or minimising dysfunction and pain in adults and children with physical impairment, to enable them to achieve the highest possible level of independence in their lives
• Preventing recurring injuries and disability in the workplace, at home, or during recreational activities and promoting community health for all age groups.
Physiotherapists use:
• Skilled evaluation
• Hands on therapy such as mobilisation, manipulation, massage and acupressure
• Individually designed exercise programmes
• Relaxation techniques
• Hydrotherapy and biofeedback
• Electrotherapy equipment, heat, ice and traction to relieve pain and assist healing and recovery
Physiotherapists may work in:
• Public and private hospitals
• Private practice
• Community health centres
• Day care centres and nursing homes
• Sports centres and with sporting teams
• Schools and pre-schools
• Research areas
• Occupational health units
• Training institutions
• Health policy development units
• Special centres for people with physical disabilities
3. Dietitian
A dietitian is a qualified health professional who is registered with the HPCSA. He/she will need a minimum qualification of a four year undergraduate scientific dietetics degree or a two year postgraduate nutrition and dietetics degree with training in all aspects and fields of nutrition therapy. There is a wide scope of practice for dietitians.
Dietitians are qualified to understand and interpret the science of food and nutrition, access nutritional needs, advise on nutrition and diet for general good health or special needs e.g. medical conditions, athletes, Etc., as well as implement and manage nutrition services and programs, undertake research and develop nutrition communications, programs and policies.
Clinical dietitians are able to address a wide variety of medical conditions. Obesity, being a focus of most dietitians, remains of great concern especially in South Africa where statistics have shown an increase in the prevalence of overweight and obese adults and children. Nutrition therapy is one of the cornerstones of treatment when it comes to the prevention and treatment of obesity as well as the prevention of the development of chronic diseases of lifestyle such as diabetes, heart disease (high blood pressure, high cholesterol) and cancer.
Dietitians are expertly trained to provide nutrition therapy for the following conditions: liver disease, kidney disease, HIV / AIDS, TB and throat, stomach and intestinal disorders such as IBS, Crohn’s, ulcerative colitis, constipation, flatulence and diarrhea. They also form a part of the valuable members of the multidisciplinary team in conditions such as food allergies and intolerances as well as eating disorders. Other nutritional services include: sports nutrition and the various stages during a person’s lifecycle i.e. pregnancy, infancy, childhood, adulthood right through to old age.
Principles of Client Referral
When considering referring a client to another fitness or healthcare specialist, ask the following questions:
1. Is the professional who you are referring the client to specifically trained/equipped to diagnose the clients condition?
2. Is the referral in the best interest of the health of the client?
How to Refer a Client
It will always be in the best interest of the client that referral occurs within a network of healthcare professionals who are able to interact amongst each other.
The following steps will enable referral to occur efficiently:
1. Create strong professional relationships with a variety of healthcare professionals
2. Inform the client that they will be referred to another healthcare profession for more specialized treatment. Include:
• Reasons for Referral
• Scope of practice of the specific healthcare professional
• Benefits of treatment
• Possible costs of treatment
3. Write a professional referral letter to the healthcare professional. Include the following:
• Date of referral
• Name, age and gender of client
• Description of condition requiring referral
• Details of any screening tests already performed
• Signature and personal details of referring fitness professional