ACSM Risk Factor Stratification

Does my client need a physician’s clearance before I start them on an exercise program? How do I use the ACSM risk factor chart in the book?

Proper screening of a client is essential for safety reasons. Both your personal trainer certification study materials and group fitness instructor study materials talk about ACSM risk factors (see the ACE Personal Trainer Manual 3rd edition on pgs 157-158, and the ACE Group Fitness Instructor Manual pages 150 – 151). The online version of ACSM risk factors chart is here.

Determining the need for a doctor’s clearance is a three step process for personal trainers and other fitness professionals.

The first step is to look at the risk factors and add up how many your client has (family history, smoking, obesity, etc).

The second step is to look at the Initial ACSM Risk Factor Stratification and decide what the client’s risk level is (low, moderate, high) based on their total score from the first step.

The third step is to look at the ACSM Recommendations for Physician Supervision During Exercise Test/Medical Exam and Exercise Test Recommendation (Table 5.2 & 5.3 PT, Table 5.3 & 5.4 GFI) and decide what you are “doing” with your client. Are you performing an exercise test? Are you programming an exercise plan? Moderate or vigorous? Submaximal or maximal? These decisions determine if you need a doctor’s clearance.

For example…You have a moderate risk client (top row, middle column) you would like to perform a sub-maximal test on. According to the chart, a doctor’s recommendation is ‘not necessary’ before you proceed.

But…if you have a moderate risk client and you wish to set them up with vigorous exercise, then a doctor’s recommendation/clearance is ‘recommended’ before you proceed.

Questions about the ACE certification exam? Contact an Education Consultant at 1-888-825-3636 x782 or support@acefitness.org