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Appendix D-2 Skelton Materials

Unit D514 Design, agree and adapt a physical activity programme with older adults with a history or high risk of falls

Introduction

In everyday clinical practice, presentation following a fall represents a critical point in the health of an older person. Falls are not accidents but are the symptomatic manifestation of underlying causal factors. Falls, fall related injuries and the fear associated with falling or postural instability have a significant cost to the National Health Service, the individual and their family and carers. Exercise has been shown to have a central role to play in preventing and managing falls. The provision of specific, progressive strength and balance exercises tailored to individual need and delivered by specialist exercise professionals is positioned as a core component of multi-factorial interventions to prevent and manage falls in frailer older people.

Advanced instructors who are responsible for designing, delivering, monitoring and evaluating structured, individualised physical activity programmes for patients/clients with a history or high risk of falls, must have a range of appropriate knowledge and skills that are aligned with current evidence-based, best practice guidelines. These instructors should have established close liaison with falls and fracture and rehabilitation services in their local area and with relevant carers where appropriate with agreement.

This unit is designed to cover the multi-factorial nature of falls prevention and management, including the skills and knowledge required to prescribe safe and effective exercise programmes for this patient/client group. These programmes must be based on relevant information from assessment, diagnosis and treatment/management as well as on a sound understanding of the risk factors and risk stratification involved. There are particular challenges associated with the physical activity management of this client group as they may have movement control, balance and gait problems associated with ageing, inactivity, significant loss of muscle strength and power; visual, vestibular or propriceptive disorders and neuromuscular/cognitive effects resulting from inappropriate medication. They may also have psychological issues such as fear of falling, loss of confidence, feelings of isolation and dependence. An understanding of the aims of rehabilitation, and the potential effects of therapy led approaches, assessed through relevant outcomes will inform and integrate the physical activity intervention for both clients and professionals involved. The unit is divided into two parts. The first part (pages 2 and 3) describes the two things you have to do. These are:

D514.1 Design and agree a physical activity programme with patient/client with a history or high risk of falls

D514.2 Deliver, review and adapt a physical activity programme with patient/client with a history or high risk of falls

The second part (pages 4 – 7) covers the unit specific knowledge and understanding you must have.

Target Group

This unit is for advanced fitness instructors who plan, conduct and review programmes to address the needs of patients/clients with a history or high risk of falls. They will normally be working without direct supervision.

Linked Units

This unit is one of a suite of Level 4 national occupational standards and should only be attempted on completion of the core Level 3 physical activity and exercise units.

D467 Adapt a physical activity programme to the needs of older adults

Introduction

Summary

Physical activity and physical fitness can make a major contribution to the continued health and functional capacity of people aged 50 and over. Increased, regular physical activity improves physical fitness despite the physical decline associated with ageing. It also helps to preserve functional capacity and improve quality of life which will become increasingly important with advanced age. It is crucial that instructors who work with this age group understand the ageing process and its implications for practice in order to meet the higher duty of care. Instructors need to be able to apply this knowledge when conducting pre-participation screening, and developing, adapting and implementing appropriate physical activity programmes to meet the diverse needs of older adults. Highly competent communication skills are also important. This unit, however, only covers working with apparently healthy (i.e. asymptomatic) older adults or those with medical conditions carrying a low risk of adverse, exercise-related events.

The document is divided into two parts. The first part describes what you have to do. This is:

D467.1 Adapt a physical activity programme to the needs of older adults

The second part covers the specific knowledge and understanding you must have.

Target Group

This standard is for fitness instructors/personal trainers who plan, conduct and review programmes to address the needs of older adults. They will normally be working without direct supervision.

 

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