Designing physical activity for antenatal and postnatal clients UV31473 R/504/3339 Learner name:

VRQ

Learner number:

VTCT is the specialist awarding body for the Hairdressing, Beauty Therapy, Complementary Therapy, Hospitality and Catering and Sport and Active Leisure sectors, with over 45 years of experience. VTCT is an awarding body regulated by national organisations including Ofqual, SQA, DfES and CCEA. VTCT is a registered charity investing in education and skills but also giving to good causes in the area of facial disfigurement.

Statement of unit achievement By signing this statement of unit achievement you are confirming that all learning outcomes, assessment criteria and range statements have been achieved under specified conditions and that the evidence gathered is authentic. This statement of unit achievement table must be completed prior to claiming certification.

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Date achieved

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Assessor tracking table All assessors using this Record of Assessment book must complete this table. This is required for verification purposes.

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Designing physical activity for antenatal and postnatal clients The aim of this unit is to provide you with the knowledge and understanding required to design appropriate physical activity programmes which safely address the needs of antenatal and postnatal participants.

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Level

3 Credit value

3 GLH

18 Observation(s)

1 External paper(s)

0

Designing physical activity for antenatal and postnatal clients products of work are likely to be the most appropriate sources of performance evidence. Professional discussion may be used as supplementary evidence for those criteria that do not naturally occur.

Learning outcomes On completion of this unit you will:

1. 2.

Be able to gather and analyse client information for antenatal and postnatal clients Be able to design and record an individualised exercise programme for antenatal and postnatal clients

3.

Understand key professional considerations when working with antenatal and postnatal clients

4.

Understand key considerations when designing exercise programmes for antenatal and postnatal clients

5.

Understand how to gather and analyse client information for antenatal and postnatal clients

Evidence requirements 1.

Environment Evidence for this unit may be gathered within the workplace or realistic working environment (RWE).

2.

Simulation Simulation is allowed in this unit for the consultation process only. However, assessment practices require you to plan a session for REAL antenatal and postnatal clients. The plan must deal with BOTH antenatal and postnatal clients and their specific needs.

3.

Observation outcomes Competent performance of Observation outcomes must be demonstrated on at least one occasion*. Assessor observations, witness testimonies and

*Please refer to the Assessment guidance section on the Achieving observations and range page.

4.

Knowledge outcomes There must be evidence that you possess all the knowledge and understanding listed in the Knowledge section of this unit. In most cases this can be done by professional discussion and/or oral questioning. Other methods, such as projects, assignments and/or reflective accounts may also be used.

5.

Tutor/Assessor guidance You will be guided by your tutor/assessor on how to achieve learning outcomes in this unit. All outcomes must be achieved.

6.

External paper There is no external paper requirement for this unit.

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Achieving observations and range Achieving observation outcomes Your assessor will observe your performance of practical tasks. The minimum number of competent observations required is indicated in the Evidence requirements section of this unit. Criteria may not always naturally occur during a practical observation. In such instances you will be asked questions to demonstrate your competence in this area. Your assessor will document the criteria that have been achieved through professional discussion and/or oral questioning. This evidence will be recorded by your assessor in written form or by other appropriate means. Your assessor will sign off a learning outcome when all criteria have been competently achieved.

Achieving range There is no range section that applies to this unit.

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Assessment guidance Outcome 1 VTCT encourages that Outcome 1 is observed, however, SkillsActive state that there is no formal requirement for practical assessment. Instead your centre may require you to produce other forms of evidence to demonstrate understanding of all criteria. For example in Outcome 1a, rather than demonstrate communication skills, you will be required to explain the communication skills which effectively establish rapport. For Outcomes 1b/c, your tutor may provide you with information on a theoretical case study (i.e. PAR-Q) which you will be required to interpret. Outcome 2 Your programme must include adaptations for both antenatal and postnatal clients.

Observations Outcome 1

Be able to gather and analyse client information for antenatal and postnatal clients* You can:

a.

Use communication skills to establish rapport with antenatal and postnatal clients

b.

Collect information about the antenatal or postnatal client, using appropriate screening methods

c.

Interpret the information gathered and identify any reasons for referral

d.

Observe legal and ethical responsibilities regarding screening, client records and confidentiality

*Please refer to the Assessment guidance section on the Achieving observations and range page. Observation

1

Optional

Optional

Date achieved Criteria questioned orally Portfolio reference Assessor initials Learner signature UV31473

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Developing knowledge

Achieving knowledge outcomes You will be guided by your tutor and assessor on the evidence that needs to be produced. Your knowledge and understanding will be assessed using the assessment methods listed below*: • • • • • • • • • •

Projects Observed work Witness statements Audio-visual media Evidence of prior learning or attainment Written questions Oral questions Assignments Case studies Professional discussion

Where applicable your assessor will integrate knowledge outcomes into practical observations through professional discussion and/or oral questioning. When a criterion has been orally questioned and achieved, your assessor will record this evidence in written form or by other appropriate means. There is no need for you to produce additional evidence as this criterion has already been achieved. Some knowledge and understanding outcomes may require you to show that you know and understand how to do something. If you have practical evidence from your own work that meets knowledge criteria, then there is no requirement for you to be questioned again on the same topic.

*This is not an exhaustive list.

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Knowledge Outcome 2

Be able to design and record an individualised exercise programme for antenatal and postnatal clients* You can:

a.

Design an exercise programme to meet the specific needs of antenatal and postnatal clients

b.

Apply current evidence-based guidelines to the design of exercise programmes for Frequency, Intensity, Time and Type (FITT)

c.

Select appropriate types of activity for the clients and stage of pregnancy

d.

Select appropriate alternatives or modifications

e.

Select appropriate equipment for antenatal and postnatal clients

Portfolio reference

*Please refer to the Assessment guidance section on the Achieving observations and range page.

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Outcome 3

Understand key professional considerations when working with antenatal and postnatal clients You can:

a. Explain the considerations/adaptations when working with antenatal and postnatal clients, to include: • teaching skills • structure/content of class • exercise environment

b. Explain the importance of engaging in regular continuous professional development (CPD)

c. Explain the importance of:

• undertaking thorough risk assessments • checking insurance arrangements   when working with antenatal and postnatal clients

d. Justify the importance of having an up to date first aid qualification

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Portfolio reference

Outcome 4

Understand key considerations when designing exercise programmes for antenatal and postnatal clients You can:

Portfolio reference

a. Explain the types of exercise that should be avoided antenatally and postnatally, giving reasons why

b. Explain the importance of pelvic floor exercises c. Explain how to teach pelvic floor exercises d. Explain how to check for abdominal muscle separation e. Describe the most effective way to rehabilitate the abdominal wall, post-birth

f.

Explain the general guidelines on appropriate stretching for antenatal and postnatal clients

g. Explain why it is inappropriate to use babies as a resistance or weight during exercise

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Outcome 5

Understand how to gather and analyse client information for antenatal and postnatal clients You can:

a. Explain the considerations when establishing and developing an

effective working relationship with antenatal and postnatal clients

b. Explain the importance of antenatal exercise screening c. Summarise information to be collected by the fitness professional d. Discuss the sources of information and advice available when working with antenatal and postnatal clients

e. Explain under which circumstances it may be appropriate to obtain written consent from healthcare professionals

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Portfolio reference

Unit content This section provides guidance on the recommended knowledge and skills required to enable you to achieve each of the learning outcomes in this unit. Your tutor/assessor will ensure you have the opportunity to cover all of the unit content.

Outcome 1: Be able to gather and analyse client information for antenatal and postnatal clients Effective communications skills: Personalised service, friendly and welcoming, active listening, open questions, empathy, positive body language, show respect, gain mutual confidence, gain mutual trust, determine needs, review needs. Collect and interpret information: Collect relevant information, screen participants, identify reasons for referral, identify adaptations/modifications, devise appropriate class/programme. Observe legal and ethical responsibilities: Screening, records, confidentiality.

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Outcome 2: Be able to design and record an individualised exercise programme for antenatal and postnatal clients Programme design: Implications, goals and objectives of programme, warm-up and cool down, antenatal and postnatal exercise guidelines, safety considerations, types of exercises, consider principles of training and the FITT principle, abdominal and pelvic floor focus, for each exercise include (teaching points, frequency, intensity, time). Goals/objectives: Maintenance of cardiovascular fitness, maintenance of functional muscular strength and endurance, improved posture, pelvis and spine stability, improved motor skills, balance and co-ordination, pelvic floor muscle education and improved strength and function, resumption of appropriate safe and effective postnatal exercise, quicker return to non-pregnancy state. Exercise guidelines: Range of exercise guidelines, exercise frequency, exercise intensity, exercise type, duration of exercise, guidelines as they apply to antenatal and postnatal clients, guidelines for previously active and previously inactive clients, never exceed heart rate of 140bpm, temperature should never exceed 100°F (38°C). Recommended types of physical activity: Recommended exercise duration/ frequency/type, muscles to strengthen (scapula retractors, lumbar paravertebrals, gluteus maximus and medius, quadriceps, abdominals, pelvic floor), core stability, practical and functional skills, stretching, relaxation and stress management programmes, group exercise modes (low impact aerobics, step training (step no higher than 10cm), yoga, Pilates, waterbased exercises, cycling), modified resistance training exercises, offer

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alternative exercises and positions, exercise after second trimester (do not lie supine, rotations, twisting, isometric exercises). Alternative exercises and modifications: Positional changes to avoid supine hypotensive syndrome, splinting techniques (using a towel or pelvic belt), progression exercises, water-based exercise, cueing for technique, emphasising the lengthening of the spine and encouraging space between the ribcage and pelvis. Appropriate equipment for antenatal and postnatal clients: Relevant to type of class, adaptations/modifications for individual, resistance (fixed, free), cardiovascular machines, portable equipment.

Outcome 3: Understand key professional considerations when working with antenatal and postnatal clients Considerations/adaptations: Teaching skills – clear and concise instructions, communication and interpersonal skills, personalised instruction, listening and responding, body language, positive and supportive attitude, quality of demonstration, positioning, cueing, repeating demonstrations, breaking down demonstrations, ensuring client understanding, analysing and modifying client technique, safe transition, consideration of guidelines and effects of pregnancy, reinforcement of safety guidelines. Structure/content of class – educate participants for safe participation, graduated (warm-ups, cool downs), meet aims and objectives of class/ individual participants, stage of pregnancy (trimester), follow antenatal/postnatal exercise guidelines, FITT guidelines, low impact, positioning for safety and comfort, heart rate below 140bpm, abdominal and pelvic floor focus, regular breaks (toilet, rehydrate). Exercise environment – safety, space, ventilation, temperature, appropriate equipment, group size, hazards. Engaging in regular CPD: Keep up to date with current concepts/new ideas/ research and thinking, requirement of Register of Exercise Professionals (REPs), insurance.

Assess risk before/during/after class, assess on individual basis (screening), thorough consultation process, consider all variables, assess risk (participants, environment, equipment). Reduce risk through risk assessments, observation/monitoring/cueing skills to ensure safe exercise intensity, giving toilet and hydration breaks, technique correction (reinforcement of posture, joint alignment), speed of instruction, safe transitions, pelvic floor awareness. Pros and cons of different positions to take into account supine and postural hypotensive syndromes, pelvic girdle pain, carpal tunnel syndrome, rib pain, gastric reflux and low back pain, the standing position for functionality/balance/optimal pelvic floor muscle function. Checking insurance arrangements – adequately insured, higher risk group, specialist skills. Importance of having an up to date first aid qualification: Higher-risk exercise environment, increased risk of injury, greater probability of needing first aid skills, to be able to deal with emergency situations, CPD to keep up to date with current concepts/research/thinking.

Importance of: Undertaking risk assessments – Minimise risk of injury, adherence to legislation, instructors (appropriate training/ qualifications to work with this specific group).

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Outcome 4: Understand key considerations when designing exercise programmes for antenatal and postnatal clients Types of physical activity to be avoided: Excessive twisting and turning activities, breath holding activities, asymmetrical weight bearing activities, one-legged activities, prolonged standing static exercise, high-intensity physical activities, hip abduction, supine exercise after the first trimester, vigorous or exhaustive exercise, contact sports or exercise at risk of abdominal trauma, heavy weights, excessive breaststroke, exercises that cause pain, reasons for avoiding (dizzyness, high blood pressure, hip adduction, symphysis pubis dysfunction (SPD), risk of damage to foetus). Importance of pelvic floor exercises: Sling of muscles/ligaments/sheet-like tissue (stretches from pubic bone to base of spine), structure and function of the abdominals and pelvic floor muscles, supports (bladder, bowel and uterus), control over bladder and bowel movement, weak vaginal muscles (sex less satisfying, possibility of prolapse), weak pelvic floor (may result in stress incontinence), postnatal stress incontinence common, control and relaxation of labour and alignment of hip and sacroiliac joints, constipation in pregnancy (more stress on pelvic floor). Teaching pelvic floor exercises: Transversus abdominis and spinal stabilisation, cueing, routines, visualisation, teach independently, teach prior to integration with other abdominal and pelvic stabilisation exercises, Kegel’s exercises, do exercises anywhere and regularly, establish routine. Abdominal separation (diastasis recti): Defining abdominal separation, testing for abdominal separation (knees bent, feet

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flat on floor, place two fingers across the abdomen around the tummy button area and gentle apply pressure, ask client to slowly raise head and shoulders off floor and hold, ensure no holding of breath, lower with control, if gap appears to be wider than two fingers try three fingers and repeat test, any more than two fingers, no forward flexion until gap reduces. Rehabilitation of abdominal wall, post-birth: Effective postnatal exercise programme, core exercises, target pelvic floor and transversus abdominus, include resistance and cardiovascular training. Stretching: Types of stretching, general guidelines, muscles to stretch (levator scapula, thoracolumbar area, hip flexors, iliotibial band, piriformis, hamstrings, hip adductors, gastrocnemius, soleus), stretching should be gentle, possibility of excessive flexibility due to the hormone relaxin, relaxin present until six months postnatally. Inappropriateness of using babies as resistance or weight: Health and safety implications, ethical issues, disruption to class, distress to baby, risk of harm to baby (e.g. shaking of brain, impact).

Outcome 5: Understand how to gather and analyse client information for antenatal and postnatal clients Considerations when establishing and developing effective working relationships: Perceived body image, confidence, mood, sleep deprivation, ethical considerations, anxiety, depression. Pre-activity screening: Importance of, risk assessment, method of gathering information, screening information used for goal setting and programme design, legal requirement, ethical responsibilities of the instructor. Information to be collected: Lifestyle, medical and pregnancy history, physical activity history, physical activity preferences, attitude and motivation to participate, current fitness level, stage of readiness, methods of gathering information (interview, validated questionnaire, physical assessment, observation). Information and advice available: Internet sources, journals, books, guidelines (Royal College of Obstetricians and Gynaecologists), SkillsActive, REPs, National Health Service (NHS), ACOG (American Congress of Obstetricians and Gynecologists). Obtain written consent from healthcare professionals: Special circumstances, risk identified, past history of miscarriage, problems in pregnancy, multiple births, premature labour, warning signs/ symptoms, complications, if low risk then OK to exercise.

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Notes

Use this area for notes and diagrams

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