Observation of a client during a fitness assessment performed by a personal trainer refers to carefully examining the client’s static posture and active movement patterns. This process helps trainers identify any imbalances, asymmetries, or limitations that may impact the client’s performance and safety during exercise (Clark et al., 2014). One approach to observing a client involves a three-part assessment, which includes a postural assessment, a movement analysis, and a flexibility assessment.
Postural assessment: This involves evaluating the client’s static posture while standing, sitting, or lying down. The trainer looks for any deviations or misalignments in the body’s natural alignment, which could indicate muscle imbalances, joint restrictions, or other issues that may need to be addressed in their exercise program (Kritz & Cronin, 2008).
In Chapter 4, Section 3, we have discussed the topic of posture, examined Common Postural Deviations, and analyzed the impact of sitting and phone usage on posture. In this section, we will guide you on conducting a postural assessment effectively.
Movement analysis: This component of the observation process examines the client’s active movement patterns during various exercises or functional movements. The trainer assesses these movements’ quality, control, and efficiency, identifying any compensations, weaknesses, or imbalances that may contribute to injury or limit performance (Cook et al., 2006).
Flexibility assessment: Lastly, the trainer evaluates the client’s flexibility and range of motion in specific joints and muscle groups. This assessment can help identify areas of tightness or restriction, which may impact the client’s overall movement and function (Norkin & White, 2016).
A comprehensive fitness assessment can also include balance and core assessments. Incorporating balance and core assessments into a fitness assessment allows for a more comprehensive understanding of the client’s overall functional capabilities and potential areas for improvement.
A personal trainer can gather crucial information through these observation techniques to design an effective and safe exercise program tailored to the client’s unique needs and goals. Addressing identified issues through targeted exercises, stretches, and modifications can help improve overall function and reduce the risk of injury.
Postural assessment involves observing and analyzing a person’s posture to identify potential issues or imbalances affecting their health, mobility, and overall posture. Personal trainers and health professionals commonly use this practice to assess and diagnose musculoskeletal imbalances, prevent injury, and develop effective exercise programs.
Posture refers to the relative arrangement of the body at any given moment, which is a composite of the positions of the body’s various joints. The position of each joint influences the position of the other joints.
Posture can generally be classified into two types: static and dynamic. It can also be further divided into correct (or neutral) and faulty (or poor) (Physio-Pedia, 2023).
Static posture represents the alignment of the body’s segments or how a person holds themselves “statically” or “isometrically” in space.
Postural assessment involves observing and analyzing a person’s posture to identify potential issues or imbalances affecting their health, mobility, and overall posture. Personal trainers and health professionals commonly use this practice to assess and diagnose musculoskeletal imbalances, prevent injury, and develop effective exercise programs.
Maintaining proper postural positions involves multiple postural muscles, generally, deeper muscles with higher concentrations of type I muscle fibers that hold static positions or low-grade isometric contractions for extended periods. Good posture or structural integrity is the state of musculoskeletal alignment and balance that allows muscles, joints, and nerves to function efficiently.
The correct posture entails horizontal alignment of the pelvis, providing a balanced foundation for the lumbar vertebrae. The concave curve of the lumbar spine and the convex curve of the thoracic regions of the spine are sinusoidal and well-balanced, such that the cervical spine has a small concave curve. The head position is aligned with the pelvis, falling within the center of gravity.
Characteristics of correct alignment include:
However, if a participant exhibits deviations from the good posture in their static position, this may indicate muscle-endurance issues in postural muscles and/or potential joint imbalances. The movement begins from a static postural position, so poor posture often signifies dysfunctional movement. Although movement screens provide valuable information about neuromuscular efficiency, a static postural assessment is a starting point for trainers to identify muscle imbalances and potential movement compensations associated with poor posture (Kendall, 2005).
A static posture assessment can offer valuable insights into the following:
For example, tight or shortened muscles are often overactive and dominate movement at the joint, potentially disrupting healthy joint mechanics.
Static posture should be observed from the anterior, posterior and lateral aspects and the observations compared to give a holistic impression of the client (Pimenta et al., 2016).
The client should remove any sweatshirts or jackets to expose as much of the body as is appropriate so the trainer can get a good visual of the body’s alignment. The client should breathe naturally while standing in a normal and relaxed position. Sometimes closing their eyes for a moment, then opening them, can help clients get into a more relaxed and normal posture.
You should start with the postural assessment, working from head to foot. Next, make a profile of the front of the client’s body, back, and both sides, looking for gross deviations and taking notes on what they see.
A photographic record may be made – with the client’s express consent, or a posture observation form completed, noting observations like “a forward head position”, etc.
Please refer to Chapter 4, Section 3, for Common Postural Deviations
Poor posture, such as lordosis (excessive inward curvature of the lower back), kyphosis (excessive outward curvature of the upper back), flat back (reduced lumbar curve), hyperlordotic posture (exaggerated lumbar curve), and swayback (forward-leaning posture with an accentuated curve in the lower back), can lead to a variety of side effects. These may include:
When observing active movement, we assess dynamic posture- the body or its segments are moving—walking, running, jumping, throwing, and lifting. Observing active movement is an effective method to determine muscle imbalances and poor posture contribute to neural control. It also helps identify movement compensations (Whiting & Rugg, 2012).
When compensations occur during movement, it usually indicates some form of altered neural action, commonly called “faulty neural control,” which normally manifests due to muscle tightness or an imbalance between muscles acting at the joint.
Movement can essentially be broken down and described by five primary movements that people perform during many daily activities (Cook et al., 2006):
Movement screens help a trainer observe the ability and efficiency with which a participant performs many activities of daily living.
After observing a demonstration from the trainer, the client should perform the movements you have shown them. During each movement, take note of the client’s ability to maintain proper joint alignment and form without pain. Ask the client how their body feels while performing each movement and make notes on their feedback (Bushman, 2017).
Assessing participants’ range of motion (ROM) using flexibility tests is an effective way to identify areas of the body that may require focused stretching. Stiff, inflexible muscles and joints can increase the risk of injury and negatively impact the performance of even the simplest tasks.
During initial assessments of posture and movement, a trainer may choose to assess the flexibility of specific muscle groups suspected to have tightness or limited movement.
After conducting the following flexibility assessments, note whether the ROM is “good” or “needs improvement” on the client’s chart. Instead of recording exact ROM measurements, address these areas by strengthening opposing muscle groups and lengthening tight muscles.
Given the importance of balance and the condition of the core musculature to fitness and overall quality of life, these baseline assessments should be collected to evaluate the need for comprehensive balance training and core conditioning during the early stages of a conditioning program. While dynamic balance correlates more closely with people’s daily activities, these tests are generally movement-specific and quite complex. Consequently, a trainer should aim to first evaluate the basic level of static balance that a participant exhibits by using the sharpened Romberg test or the stork-stand test.
Sharpened romberg Test
Sources: Black et al., 1982; Newton, 1989
Objective: To assess static balance by standing with a reduced base of support while removing visual sensory information
Equipment:
Instructions:
1)Explain the purpose of the test.
2) Instruct the participant to remove his or her shoes and stand with one foot directly in front of the other (tandem or heel-to-toe position), with the eyes open.
3) Ask the participant to fold his or her arms across the chest, touching each hand to the opposite shoulder.
4) Allow sufficient practice trials. Once the participant feels stable, instruct him or her to close his or her eyes. Start the stopwatch to begin the test.
5) Always stand in close proximity as a precaution to prevent falling.
6) Continue the test for 60 seconds or until the participant exhibits any test-termination cue. Allow up to two trials per leg position and record the best performance on each side.
Observations:
Continue to time the participant’s performance until one of the following occurs:
General interpretations: