One of the most important aspects of human learning and human health I have learned over 32 years working as an Exercise Physiologist is the importance of assisting clients to become confident learners of health concepts and their own health.
I learned much of what I use in my adult programs from observing babies and children move and learn, as my first 20 years as an Exercise Physiologist involved working with babies and their carers.
My programs use an education framework called FITERACY that I designed whilst working with babies. I use FITERACY to assist with the design and delivery of health and movement sessions that not only improve the health of the client/participant but also assist with creating confident and independent learners of health.
The FITERACY education framework uses a “low anxiety” approach to teaching and coaching to enable clients/participants to feel safe with the process of learning about their health. Once a learner feels safe to learn, they also feel safe to ask questions and self-lead their investigations into their own health.
Babies are the masters of self-guided learning, because we encourage them to self-lead, self-assess and self-progress. Rarely does an adult tell a baby they are not smart enough to make their own decisions about how they learn to crawl, communicate and investigate. But for some reason, as adults we lose this confidence.
The aim of the article below is to explain how I have set up my clinical practice to assist clients to become their own self-leaders, self-assessors and self-progressors of their health programs, by teaching them how to assess their own movements and set their own progressions.
This ultimately results in many clients no longer requiring constant instruction and creates a vibrant co-learning community of clients assisting each other.
What Is Self-Assessment?
Self-assessment is the ability to gauge individual progress through regular self-auditing of human movement (including balance), cardiovascular capacity and health behaviour changes that may impact long-term health.
Why Is Self-Assessment So Important for Sustainable Positive Health Behaviour Change?
Self-assessment removes the need for constant instruction and encourages clients to use their own observational and problem-solving skills. The development of these skills is crucial to long-term health and decision-making around health.
Observational skills are the skills we used as babies to learn the movements and speech we needed to develop in order to survive in this world during our early years. Problem-solving skills are the skills we practised as babies to overcome hurdles in our movement development and language development. As babies we did not require constant instruction to become powerful little human beings. As adults, we still have these skills, but we have been conditioned to rely on others for help or advice on basic things such as “how we move”.
What Is the Difference Between Initial Assessments and Self-Assessments?
An initial assessment involves a set of assessments chosen by a health professional, trainer, coach or instructor to determine safe exercise prescriptions and guidance for clients wishing to embark on a healthy lifestyle change.
This initial session can be used to discover your client’s learning style, and how to create an engaging learning environment from the very first meeting. I use this opportunity to assist my client/participant to become familiar with the purpose of each of the assessments and what an improved score can mean for their health progressions.
Right from the outset I start the process of helping my participants design their own assessments by asking them how they could mimic this assessment in their own environment.
E.g. Measuring cardiovascular capacity at home with a 6-minute walking track.
Turning Initial Assessments into Self-Assessments
It is important to ensure that some of your initial assessments can be replicated in the home environment. Choose assessment areas that are repeatable and easy to measure, and that can be associated easily with areas of health improvement.
Cardiovascular Capacity
Choose some tests that use standardised norms, such as the 6-minute walk test. Don’t be afraid to be creative with choosing initial assessments. Initial assessments should also have some individual meaning to a client, not just be random numbers compared to norms all the time.
Encourage clients to discuss ideas of how they may be able to self-assess improvements in their own cardiovascular capacity. For example, use a 10-minute stationary cycle score measuring HR response, distance or speed if a client has a stationary cycle at home or uses your gym regularly. Is your client able to walk around their block and time themselves once per week, and record their breathing scores before and after a walk?
Single Leg Balance
Single leg balance scores can be an easy method to gauge self-improvement, but only if these balance tests are demonstrated correctly during an initial assessment. I find many balance tests actually teach a person how to stand and wobble for long periods, and are actually reinforcing shoulder and hip instability.
By teaching balance training correctly during this very first initial balance test, and encouraging balance assessments as a daily practice at home, clients become self-assessors of their progress each day.
Balance training is the foundation of all strength training within my clinical gym setting, so all clients are encouraged to self-assess their balance prior to starting their session. This balance assessment can assist with acknowledging areas of postural dysfunction that may occur during a day of sitting in a chair, gardening, or even sleeping in an awkward position for the night.
Most importantly, self-assessing single leg balance can reveal any areas of pain that may be present during pelvic instability, and will then determine the exercises that would be most beneficial that day. I teach my clients to be aware of any daily changes in postural stability, as progressions in load or time will need to be adjusted as a result of this self-assessment.
Functional Breathing
Learning how to conduct functional breathing assessments can also become an easy self-assessment for clients to apply. The BOLT score (Body Oxygen Level Test) is an assessment used in courses such as The Oxygen Advantage course.
Teaching clients the biomechanics, biochemistry and science of respiration during their initial assessments assists clients with understanding the importance of functional breathing, and the impact dysfunctional breathing can have on cardiovascular, musculoskeletal, biochemistry and mental health.
Self-assessing a functional breathing score at the beginning of each session, and repeating this assessment a few hours following a session, is a valuable way to assess whether a programmed session resulted in a lower or improved functional breathing score. Ultimately, exercise and movement should be improving our breathing scores rather than reducing our functional breathing.
How Encouraging Self-Assessment Has Helped My Clinical Gym Setting Become an Educational Centre
As mentioned at the beginning of this article, I walk into my BrainFit gym each day and am excited to be part of a vibrant co-learning community.
I love observing my clients/participants go through their self-assessments at the start of their sessions. They then discuss their self-assessed scores with me, and together we design a set of exercises that suit their movement needs for the day. Each client understands how their movement needs can change each day, dependent on their balance scores and self-assessment of pain that may have surfaced over the last few days after their daily home or work activities.
I love observing how much time they put into their breathing mechanics rather than exercising without thinking about their breathing function.
I love noticing how their confidence grows as they get creative with designing their own movement patterns. Clients of all ages are designing their own movement patterns that involve being aware of their shoulder and hip mobility and stability. They can now design their own slow, often rhythmical movement patterns that work around their own individual restrictions, such as old injuries or joint replacements.
I love observing how they slow their breathing down to match their movements, and comment on how the pattern they made up felt like a workout.
I love that all these patterns can be completed in their home environment, without me having to be there.
I love learning from my clients as they present ideas they have investigated, and together we discuss these ideas and learn how to critically think about health information together.
And most of all, I love that soon they probably won’t need me any more, and that they have developed enough confidence to assist others with what they have learned. I love that by providing the opportunity for adults to feel safe to learn, they can feel connected to their own bodies, just like we did as babies.
About the Author, Brodie Cambourne
