Recently I was looking through some material on risk management in the fitness industry. Thought some here might be interested.
Regarding Legal and Professional Responsibilities.
Legal liability concerns the responsibilities recognized by a court of law. Those liabilities may be reduced through adherence to the appropriate standard of care, and the implementation of certain risk management principles.
Standard of care means that the quality of services provided in your class setting is commensurate with current professional standards. An instructor who failed to meet that standard could be found negligent by a court of law.
Negligence is usually defined as a failure to act as a reasonable and prudent person would act under a similar circumstance. This definition has 2 important components. First, a failure to act refers to acts of omission as well as acts of commission. In other words an instructor can be sued for not doing something that should have been done as well as for doing something that should NOT have been done. Second, the appropriateness of the action taken is considered regarding the reasonable and prudent professional standard.
4 elements must be shown to exist to substantiate a charge of negligence. First, that the defendant had a duty to protect the plaintiff. Second, that the defendant failed to exercise the standard of care necessary to perform that duty. Third, that such failure was the cause of the injury. Fourth, that the damage or injury to the plaintiff did occur.
Areas of responsibility.
As a Fitness Professional you have 6 major areas of responsibility. These are: health screening, programming, instruction, supervision, facilities, and equipment.
Health Screening.
Instructors must compile a medical history for each student that documents any existing conditions that might affect performance in training. Based on health risk factors, students are categorized as: low risk, moderate risk, or high risk.
For each of the following, add 1 risk factor.
Family history
· Myocardial infraction, coronary revascularization, or sudden death before age 55 in father or other first degree male relative.
· Myocardial infraction, coronary revascularization, or sudden death before age 65 in mother or other first degree female relative.
Cigarette smoking
· Current cigarette smokers or those who quit within the previous six months.
Hypertension
· Systolic blood pressure >= 140 mmHg or diastolic blood pressure >= 90 mmHg, confirmed by measurements on at least 2 separate occasions, or on anti-hypertensive medications.
Dyslipidemia
· Low-density lipoprotein (LDL) cholesterol >= 130 mg/dL or HDL cholesterol < 40 mg/dL, or on lipid-lowering medication.
· If total serum cholesterol is all that is available, use serum cholesterol >= 200 mg/dL
Impaired glucose fasting
· Fasting blood sugar >= 100 mg/dL confirmed by measurements on at least 2 separate occasions.
Obesity
· Body mass index (BMI) >= 30 kg/m2 OR
· Waist girth > 102 cm (40 inches) for men and >= 89 cm (35 inches) for women OR
· Waist / hip ratio >= 0.95 for men and >= 0.86 for women.
Sedentary lifestyle
· Persons not participating in a regular exercise program or not meeting the minimal recommendations from the Surgeon Generals Report / USDA Guidelines.
If HDL cholesterol score is > 60 mg/dL, subtract 1 risk factor.
Risk stratification categories.
1. Low Risk : Younger individuals (men < age 45, women < age 55) who have no more than 1 risk factor.
2. Moderate Risk : Older individuals (men > age 45, women > age 55) who have 2 or more risk factors.
3. High Risk : Individuals showing signs / symptoms OR Individuals with known cardiovascular disease, pulmonary disease, or metabolic disease.
Those with categorized as Moderate Risk should get a medical clearance before starting a high intensity exercise program.
Those categorized as High Risk should get a medical clearance before starting a moderate OR a high intensity exercise program.
Exercise Programming.
The programming of the exercise regimen should be appropriate for the health and fitness level of the student. The intensity rating of a given regimen can be categorized by using percent of maximum heart rate (MHR).
There are various formulas available for calculating MHR, all of which have some have some inaccuracies due to differences in each individual. The American College of Sports Medicine (ACSM) recommends using the following formulas to determine MHR in men and women that are 18 years or older.
MHR = 208 (0.7 x age)
ACSM recommends the following exercise intensities for individuals based on their fitness levels
Activity level : Sedentary
Fitness classification : Poor
30 45 % MHR
Activity level : Minimal physical activity
Fitness classification : Poor / fair
40 55 % MHR
Activity level : Sporadic physical activity
Fitness classification : Fair / average
55 70 % MHR
Activity level : Regular physical activity
Fitness classification : Average / good
65 80 % MHR
Activity level : High amounts of physical activity
Fitness classification : Good / excellent
84 94 % MHR
Instruction.
Safe and effective instruction mandates that the instruction provided is both adequate and proper. Adequate instruction refers to the amount of direction given to participants before and during class. Proper instruction is instruction that is factually correct. An instructor can be found liable for injuries resulting from an exercise that was not demonstrated properly or from an unsafe exercise that should not have been included in class. Instructional techniques used by a group fitness instructor should be consistent with professional standards.
Instructors are also not to diagnose or suggest treatment for injuries, as this is beyond their professional scope of practice. Instead, it is strongly advised that the instructor suggest they contact their doctor.
Supervision.
The instructor is responsible for supervision of all aspects of the class. The size of the class should be kept to what can be effectively monitored.
Facilities.
The training area must well lit and be free from unreasonable hazards, and be appropriately set up for the type of activity being taught. This relates to padded training mats for the grappling arts and cushioned flooring used for the striking arts, as well as the amount of free space around each individual while working out. Bathrooms and the changing areas must also be kept clean and sanitary. Signs must be posted around areas where the student could possibly trip or slip.
Equipment.
First, this applies to appropriate attire, this includes uniform and shoes (if any), along with protective gear worn during sparring and contact training. These should be appropriate for the style and type of training and provide adequate and proper protection. If shoes are worn they should provide adequate cushioning and appropriate friction with the floor during kicking drills.
Second, this applies to training aids, such a heavy bags, body shields, and focus pads and mits. These should be kept in good condition such that they are not hazardous to use.
Third, this applies to any specific exercise or stretching equipment kept at the training center. Legal concerns center primarily on equipment selection, installation, maintenance and repair. Using homemade equipment is strongly discouraged, because if there is an injury caused by the equipment and it is shown that the equipment failed to meet basic safety and design standards, the club will be exposed to increased liability. Further, the equipment must be assembled and installed by trained technicians, and a schedule of regular service and repair should be established and documented.
Regarding Legal and Professional Responsibilities.
Legal liability concerns the responsibilities recognized by a court of law. Those liabilities may be reduced through adherence to the appropriate standard of care, and the implementation of certain risk management principles.
Standard of care means that the quality of services provided in your class setting is commensurate with current professional standards. An instructor who failed to meet that standard could be found negligent by a court of law.
Negligence is usually defined as a failure to act as a reasonable and prudent person would act under a similar circumstance. This definition has 2 important components. First, a failure to act refers to acts of omission as well as acts of commission. In other words an instructor can be sued for not doing something that should have been done as well as for doing something that should NOT have been done. Second, the appropriateness of the action taken is considered regarding the reasonable and prudent professional standard.
4 elements must be shown to exist to substantiate a charge of negligence. First, that the defendant had a duty to protect the plaintiff. Second, that the defendant failed to exercise the standard of care necessary to perform that duty. Third, that such failure was the cause of the injury. Fourth, that the damage or injury to the plaintiff did occur.
Areas of responsibility.
As a Fitness Professional you have 6 major areas of responsibility. These are: health screening, programming, instruction, supervision, facilities, and equipment.
Health Screening.
Instructors must compile a medical history for each student that documents any existing conditions that might affect performance in training. Based on health risk factors, students are categorized as: low risk, moderate risk, or high risk.
For each of the following, add 1 risk factor.
Family history
· Myocardial infraction, coronary revascularization, or sudden death before age 55 in father or other first degree male relative.
· Myocardial infraction, coronary revascularization, or sudden death before age 65 in mother or other first degree female relative.
Cigarette smoking
· Current cigarette smokers or those who quit within the previous six months.
Hypertension
· Systolic blood pressure >= 140 mmHg or diastolic blood pressure >= 90 mmHg, confirmed by measurements on at least 2 separate occasions, or on anti-hypertensive medications.
Dyslipidemia
· Low-density lipoprotein (LDL) cholesterol >= 130 mg/dL or HDL cholesterol < 40 mg/dL, or on lipid-lowering medication.
· If total serum cholesterol is all that is available, use serum cholesterol >= 200 mg/dL
Impaired glucose fasting
· Fasting blood sugar >= 100 mg/dL confirmed by measurements on at least 2 separate occasions.
Obesity
· Body mass index (BMI) >= 30 kg/m2 OR
· Waist girth > 102 cm (40 inches) for men and >= 89 cm (35 inches) for women OR
· Waist / hip ratio >= 0.95 for men and >= 0.86 for women.
Sedentary lifestyle
· Persons not participating in a regular exercise program or not meeting the minimal recommendations from the Surgeon Generals Report / USDA Guidelines.
If HDL cholesterol score is > 60 mg/dL, subtract 1 risk factor.
Risk stratification categories.
1. Low Risk : Younger individuals (men < age 45, women < age 55) who have no more than 1 risk factor.
2. Moderate Risk : Older individuals (men > age 45, women > age 55) who have 2 or more risk factors.
3. High Risk : Individuals showing signs / symptoms OR Individuals with known cardiovascular disease, pulmonary disease, or metabolic disease.
Those with categorized as Moderate Risk should get a medical clearance before starting a high intensity exercise program.
Those categorized as High Risk should get a medical clearance before starting a moderate OR a high intensity exercise program.
Exercise Programming.
The programming of the exercise regimen should be appropriate for the health and fitness level of the student. The intensity rating of a given regimen can be categorized by using percent of maximum heart rate (MHR).
There are various formulas available for calculating MHR, all of which have some have some inaccuracies due to differences in each individual. The American College of Sports Medicine (ACSM) recommends using the following formulas to determine MHR in men and women that are 18 years or older.
MHR = 208 (0.7 x age)
ACSM recommends the following exercise intensities for individuals based on their fitness levels
Activity level : Sedentary
Fitness classification : Poor
30 45 % MHR
Activity level : Minimal physical activity
Fitness classification : Poor / fair
40 55 % MHR
Activity level : Sporadic physical activity
Fitness classification : Fair / average
55 70 % MHR
Activity level : Regular physical activity
Fitness classification : Average / good
65 80 % MHR
Activity level : High amounts of physical activity
Fitness classification : Good / excellent
84 94 % MHR
Instruction.
Safe and effective instruction mandates that the instruction provided is both adequate and proper. Adequate instruction refers to the amount of direction given to participants before and during class. Proper instruction is instruction that is factually correct. An instructor can be found liable for injuries resulting from an exercise that was not demonstrated properly or from an unsafe exercise that should not have been included in class. Instructional techniques used by a group fitness instructor should be consistent with professional standards.
Instructors are also not to diagnose or suggest treatment for injuries, as this is beyond their professional scope of practice. Instead, it is strongly advised that the instructor suggest they contact their doctor.
Supervision.
The instructor is responsible for supervision of all aspects of the class. The size of the class should be kept to what can be effectively monitored.
Facilities.
The training area must well lit and be free from unreasonable hazards, and be appropriately set up for the type of activity being taught. This relates to padded training mats for the grappling arts and cushioned flooring used for the striking arts, as well as the amount of free space around each individual while working out. Bathrooms and the changing areas must also be kept clean and sanitary. Signs must be posted around areas where the student could possibly trip or slip.
Equipment.
First, this applies to appropriate attire, this includes uniform and shoes (if any), along with protective gear worn during sparring and contact training. These should be appropriate for the style and type of training and provide adequate and proper protection. If shoes are worn they should provide adequate cushioning and appropriate friction with the floor during kicking drills.
Second, this applies to training aids, such a heavy bags, body shields, and focus pads and mits. These should be kept in good condition such that they are not hazardous to use.
Third, this applies to any specific exercise or stretching equipment kept at the training center. Legal concerns center primarily on equipment selection, installation, maintenance and repair. Using homemade equipment is strongly discouraged, because if there is an injury caused by the equipment and it is shown that the equipment failed to meet basic safety and design standards, the club will be exposed to increased liability. Further, the equipment must be assembled and installed by trained technicians, and a schedule of regular service and repair should be established and documented.
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