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WORLDWIDE SURVEY OF FITNESS TRENDS FOR 2011

Thompson, Walter R. Ph.D., FACSM, FAACVPR

doi: 10.1249/FIT.0b013e3181f96ce6
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Learning Objectives From this article, the reader should understand the following concepts:

• The difference between a fad and a trend

• Worldwide trends in the commercial, corporate, clinical (medical fitness), and community health and fitness industry

• Expert opinions about identified fitness trends for 2011

The annual ACSM's Health & Fitness Journal® worldwide survey of health and fitness professionals, now in its 5th year, supported some previous trends, revealed some interesting new trends, and quashed a presumed trend in the way health and fitness facilities are currently staffed. Some trends that appeared in the top 20 last year did not make the list for 2011. There have been and perhaps will always be a number of attempts by profit and not-for-profit organizations to predict the future of the fitness industry in an effort to influence market direction. This ACSM assessment and analysis is much different in that it not only surveyed thousands of certified fitness professionals around the world but also sought out experts to comment on the results.

Walter R. Thompson, Ph.D., FACSM, FAACVPR, is a regents professor of exercise science in the Department of Kinesiology and Health (College of Education) at Georgia State University, where he has a second academic appointment in the Division of Nutrition (School of Health Professions, College of Health and Human Sciences). He has lectured on health promotion and fitness topics in 23 countries on five continents. He has served on the ACSM Board of Trustees and was twice elected a member of its administrative council. He is a past chairman of the ACSM committee on certification and registry boards, past chairman of the CAAHEP Committee on Accreditation for the Exercise Sciences, and he is currently serving as the chairman of the ACSM Publications Committee, chairman of the ACSM American Fitness IndexTM Advisory Board, and chairman of the NSF International Joint Committee on Health Fitness Facilities Standards.

This year's survey included a number of innovations that were made to be more inclusive of the health and fitness industry, and added more opinions of those working in the field, but at the same time made the survey easier to use. To make this report even more meaningful, we comment on what appears to be a growing trend in the industry, but is not supported by this survey (more on that later). This year's survey was important because it is the fifth consecutive year the survey has been published, and with the increasing demands of a sluggish economy, the results may have a greater impact on the industry.

As in past American College of Sports Medicine fitness trend surveys, respondents had to first make the important distinction between a "fad" and a "trend." Most surveys of this type rarely make a distinction but because this is a survey of trends and not fads, it is important to define each. A trend has been described as "a general development or change in a situation or in the way that people are behaving" (http://dictionary.cambridge.org). It would be totally expected, then, to see the same trends appearing for multiple years in a "trends survey." The definition of trend, after all, includes the phrase "general development" as opposed to "a fashion that is taken up with great enthusiasm for a brief period," which is the definition of a fad (http://dictionary.reference.com). During the last 5 years, the editors of ACSM's Health & Fitness Journal® have developed and widely disseminated electronic surveys to thousands of professionals to determine trends in the health and fitness industry that might help guide programming efforts for the upcoming year and into the next decade. The first survey conducted in 2006 (for 2007 trends) was the initial effort to develop a systematic way to predict the future of the health and fitness industry. A second survey followed for the year 2008, a third survey followed in 2009, and the fourth was for 2010 trends.

These annual surveys of health and fitness trends in the commercial (for-profit), clinical (medical fitness), community (not-for-profit), and corporate sectors of the industry confirmed some trends revealed in previous surveys. Some of the trends first identified for 2007 have moved up and stayed in the top 10. Some new trends appear to be emerging for 2011, whereas others have disappeared out of the top 20. Future surveys will either confirm these new trends or show that they will fall short of making an impact on the health and fitness industry and drop out of the survey, as did the stability ball, Pilates, and balance training, in 2011. Dropping out of the survey may indicate that what was perceived to be a trend in the industry was actually a fad.

This survey does not attempt to evaluate equipment, gear, tools, apparatus, or other exercise devices that may suddenly appear at clubs or during late-night infomercials often seen during the winter holidays or the week before New Year's. The survey has been designed to confirm, reconfirm, or to even introduce new trends (not fads) that have been sustained by having a proven impact on the industry according to respondents. Using this framework, it is understandable that some of the trends revealed in earlier surveys would appear again (and perhaps for several years, which is the case in several of the top 10 trends). It is as important for the health and fitness industry to pay close attention to not only those trends appearing for the first time, but also to those that do not appear this year or have been replaced on the list by other trends. ACSM's annual worldwide survey of health and fitness trends should not be confused with estimating the potential impact of new equipment or some emerging exercise device on the bottom line in for-profit clubs. That type of information is left to the reader to determine if it fits into his or her business model.

The health and fitness industry should consider taking this information and applying it to its own settings, which may include commercial health clubs (for-profit), community settings (not-for-profit), corporate wellness programs, and medical fitness centers (clinical programs). The benefit to commercial health clubs is the establishment (or perhaps justification) of new markets, resulting in a potential for increased and sustainable revenue. Community-based programs can use the results to continue to justify an investment in their unique market segment by providing protracted programs serving families and youth. Corporate wellness programs and medical fitness centers may find these results useful through an increased service to their members and patients.

There were 31 possible trends in the 2011 survey (six fewer than for 2010); the number was reduced because of a common complaint that the survey was too long. The top 25 trends from previous years were included in the survey as were some emerging trends identified by the editors of ACSM's Health & Fitness Journal®. To create a balance, the editors represent all four sectors of the health and fitness industry (corporate, clinical, community, commercial), as well as members of academia. In the survey, potential trends were first identified, and then short explanations were written to offer the respondent a few details without inconveniencing him or her with too much reading, analysis, or interpretation. The survey was designed to be completed in less than 15 minutes. As an incentive to complete the survey, the editors offered a drawing for seven ACSM books published by Wolters Kluwer/Lippincott Williams & Wilkins and a $100 American Express gift card. These incentives helped increase participation in the survey.

As in all of the previous ACSM worldwide fitness trend surveys, the 31 potential items were constructed using a Likert-type scale ranging from a low score of 1 (least likely to be a trend) to a high score of 10 (most likely to be a trend). After each scoring opportunity, space was provided for the respondent to add comments (these proved to be very helpful in the identification of emerging trends appearing in this year's survey). At the conclusion of the survey, additional space was left for the respondent to add comments or to add potential fitness trends that were left off the list but could be considered for future surveys. The next step was to send the survey electronically to a defined list of health and fitness professionals. Using "Survey Monkey" (www.surveymonkey.com), the online survey was sent to 19,167 ACSM certified professionals (9,178 more than last year, nearly double the number of potential respondents). This list included all currently certified ACSM Certified Personal TrainersSM, ACSM Health/Fitness Instructors® (presently known as ACSM Health Fitness Specialists), ACSM Exercise Specialists® (now ACSM Clinical Exercise Specialists), ACSM Registered Clinical Exercise Physiologists®, ACSM Health/Fitness Directors®, and ACSM Program DirectorsSM. Of these, 423 were returned for bad addresses and 67 opted out, leaving 18,677 possible participants. After the 3-week window of opportunity had been completed, 2,219 responses were received, which represents a very good return rate of 12% (742 more than last year). Responses were received from just about every continent including Asia, Europe, Australia, Africa, North America, and South America.

The first step in the analysis was to collate all of the responses and then rank order them from highest (most popular trend) to lowest (least popular trend). Only the top 20 are detailed in this report. After rank ordering the responses, we asked four internationally recognized experts representing all sectors in the health and fitness industry to comment on the findings. Their analysis and commentary are included at the end of this report. Table 1 provides the top 10 results of the four previous surveys (1-4). The same top 6 trends identified in 2008, 2009, and 2010 appear as the top 6 trends for 2011, just in a different order, with fitness programs for older adults taking a jump from no. 6 in the last 3 years to no. 2 for 2011, the same spot it had in the first survey in 2007. Therefore, the 2011 survey Table 2 reinforces those findings of previous years. Dropping out of the top 20 trends for 2011 were balance training, Pilates, and stability ball (or Swiss ball). These three potential trends showed remarkable strength in past years. Pilates, as recently as last year, was no. 9 on the list and appeared as no. 7 in 2008 and 2009. Although Pilates had all of the characteristics of a trend in the industry, it may now be thought of as a fad (perhaps the next survey for 2012 will verify this statement). Appearing for the first time in the top 20 trends for 2011 were worker incentive programs (no. 17), clinical integration (no. 18), and reaching new markets (no. 19).

TABLE 1

TABLE 1

TABLE 2

TABLE 2

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Educated and Experienced Fitness Professionals

Holding on to the no. 1 spot for the last 4 years (including 2011), this is a trend that continues with education and certification programs that are fully accredited by national third-party accrediting organizations for health/fitness and clinical professionals. There will be exponential growth of educational programs at community colleges, undergraduate programs, and graduate programs at colleges and universities that will become accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) through the Committee on Accreditation for the Exercise Sciences, and more certification programs will become accredited by the National Commission for Certifying Agencies (NCCA). According to the American Kinesiology Association (AKA), the kinesiology major grew by more than 50% from 2003 to 2008 (5). This escalation, according to the AKA, means that kinesiology is a fast-growing major in the United States and perhaps around the world. It has become abundantly clear in this sluggish economy that as the market for fitness professionals becomes even more crowded and more competitive, the need for regulation, either from within the industry or from external sources (i.e., government), is growing. For example, a number of states and the District of Columbia are considering legislation to regulate personal trainers just as it does physicians, lawyers, and pharmacists. The CAAHEP and NCCA are both third-party accrediting agencies; CAAHEP for academic programs and NCCA for certification programs. Because of their independence, neither organization is directly influenced by the health and fitness industry. In 2007, CAAHEP added a personal fitness trainer accreditation for certificate (1-year) and associate (2-year) degree programs. Accreditation for the academic training of the personal fitness trainer joins academic program accreditation for exercise science (baccalaureate) and exercise physiology (graduate programs in either applied exercise physiology or clinical exercise physiology). Collaboration also has started within the fitness industry to address the issue of standardized facility practices. Coordinated by NSF International (www.nsf.org), this collaboration (known as the NSF Joint Committee on Health Fitness Facilities Standards) brings various sectors of the industry and the public together to resolve the issues of facility standards (i.e., the characteristics of a health and fitness facility). Look for these standards to be adopted by the joint committee within the year with a voluntary certification program to follow.

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Fitness Programs for Older Adults

Jumping from no. 6 in last year's survey, fitness programs for older adults is now no. 2 in the 2011 survey. As the baby boom generation ages into retirement, and because these older adults may have more discretionary money than their younger counterparts, fitness clubs may capitalize on this exponentially growing market. Falling from no. 2 in 2007 to no. 6 in 2008, 2009, and 2010, fitness programs for older adults remain a strong trend for 2011. Falling to no. 6 between 2007 and 2008 was a bit of a surprise, considering all the discussion about the baby boom generation rapidly approaching retirement age 5 years ago. This trend, however, continues to be strong, making the top 10 in each year of the survey. It is assumed that in retirement, people typically have greater discretionary money but have a tendency to spend it more wisely. Health and fitness professionals should take advantage of this growing population of retired persons by providing age-appropriate exercise programs. In 2008, the U.S. government published physical activity guidelines (http://www.health.gov/paguidelines/) that now include an entire section (Chapter 5) on the older adult. In 2007, ACSM published its own guidelines for the older adult (www.acsm.org). Both sets of guidelines indicate that the more active older adults can enjoy golf, tennis, and even an inspired game of pickle ball. The highly active older adult (the athletic old) also can be targeted by commercial and community-based organizations to participate in more rigorous exercise programs, including strength training. Even the frail elderly can improve his or her ability to perform activities of daily living when provided the appropriate quality and quantity of exercise. Health and fitness professionals would be wise to develop and sustain fitness programs for people of retirement age.

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Strength Training

Strength training moved from no. 6 on the list in 2007 and rose to greater prominence to no. 4 in 2008 and remained in that position in 2009. For 2010, strength training moved up to the no. 2 position on the list, and in 2011, dropped slightly to no. 3. This is a trend for both men and women to incorporate strength training into their exercise routines. For many years and for a good number of health clubs (both for-profit and not-for-profit), a central theme remains strength training. Historically, there are many clients who train exclusively using weights and there are still those who lift weights for body building and what commonly has been referred to as body sculpting. However, today, there are many others (both men and women) whose main focus is on using weight training to simply increase or maintain strength as they age. The Physical Activity Guidelines for Americans (http://www.health.gov/paguidelines/) indicates that adults should engage in muscle-strengthening exercises at least 2 days a week. Many health and fitness professionals today incorporate some form of strength training into a comprehensive exercise routine for both apparently healthy clients and for patients with controlled disease. It is not uncommon for cardiac rehabilitation, pulmonary rehabilitation, or metabolic disease management programs to include some form of weight training in the exercise prescription. Strength training is popular in commercial, community, clinical, and corporate health and fitness facilities for men, women, and in some cases, children.

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Children and Obesity

The problem of childhood and adolescent obesity continues to be a major health issue. As school systems face the reality of cutting programs such as physical education and recess to spend more time preparing for standardized testing in this challenging economy, this is a trend toward more programs and a potential new market for commercial and community-based organizations. Although slipping slightly to no. 4 for 2011, for the fifth year, childhood obesity programming is a trend in the health and fitness industry. Health and fitness practitioners and industry leaders see the problem of childhood obesity and its associated comorbidities as an opportunity to make an impact on a health issue that not only impacts the health care industry today, but has an even greater impact on the health of these children as they mature into adults. First Lady Michelle Obama has recently announced the formation of a childhood obesity task force who will be charged with developing federal programs addressing both physical activity and good nutrition. The 2008 Physical Activity Guidelines for Americans (http://www.health.gov/paguidelines/) devotes an entire chapter to children and adolescents (Chapter 3). The health and fitness industry has recognized this problem and is beginning to mobilize with new programs aimed specifically at children. Corporate and clinical programs also may see this as an opportunity to develop specialized physical activity programs for children of their staff and patients.

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Personal Training

The growing number of undergraduate students majoring in kinesiology (5) indicates that more students are being prepared for both allied health programs in physical therapy, occupational therapy, and sports medicine, or advanced study in kinesiology. However, students who do not go on to graduate school are finding employment in the health and fitness industry, many of them as personal trainers. As more professional personal trainers are educated and become certified, they are more accessible to more people in all aspects of the health/fitness industry. Personal training has been in the top 10 of this survey for the past 5 years and top 5 for the past 4 years. Recently, much attention has been paid to the education and certification of personal trainers. In a number of states (California, New Jersey, Massachusetts, Georgia, and several others), legislation has been introduced to license personal trainers, none of which has yet passed. Although there are some minor variations of personal training (e.g., small groups as opposed to one-on-one), respondents to this survey believe that personal trainers are here to stay and will continue to be an important part of the professional staff of health and fitness centers.

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Core Training

This trend stresses strength and conditioning of the stabilizing muscles of the abdomen, thorax, and back. Core training continues to use stability balls, BOSU balls, wobble boards, and foam rollers among other pieces of equipment. Although some have speculated, just a few years ago, that core training was a "fad," it seems to have stood the test of time as it again appears at no. 5 on our trend list. Core training typically includes the muscles of the pelvis, lower back, hips, and abdomen, all of which provide support for the spine and thorax. Exercising the core muscles may enable the client or patient to improve overall stability of the trunk and transfer that to the extremities, enabling the individual to meet the demands of activities of daily living and the performance of various sports that require strength, speed, and agility.

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Exercise and Weight Loss

Jumping six whole places from no. 12 on last year's survey is exercise and weight loss. For many years, exercise professionals have been trying to infuse a regular exercise program into the caloric restriction diets of many popular weight loss programs. Most well-publicized diet programs incorporate an exercise program into their daily routine of providing meals to their clients. This is the first time since the survey began in 2007 that the direct coupling of regular exercise and weight loss has reached the top 10. It appears as though people who are in the business of providing weight loss programs will incorporate regular exercise and caloric restriction for weight control.

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Boot Camp

Jumping eight spots from no. 16 in the last survey is the boot camp. This high-intensity structured activity program, patterned after military style training, has never been in the top 10 since this survey was initiated in 2007 and first appeared last year in the top 20. Boot camp includes cardiovascular, strength, endurance, and flexibility drills and usually involves both indoor and outdoor exercises that are typically led by an instructor who means business. Boot camps also can combine sports-type drills and calisthenics. Because of its meteoric climb in the survey rankings, it will be interesting to see in the coming years if boot camp programs continue as a trend in the fitness industry.

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Functional Fitness

Functional fitness is defined as using strength training to improve balance, coordination, force, power, and endurance to improve someone's ability to perform activities of daily living. The exercise programs reflect actual activities someone might do as a function of his or her daily living. Functional fitness first appeared on the survey in the no. 4 position in 2007 but fell to no. 8 in 2008 and no. 11 in 2009. It reappeared in the top 10 for 2010 at no. 7 and now appears as no. 9. Some survey respondents thought that there may be a relationship between functional fitness and fitness programs for older adults. Many exercise programs for this age group are composed of functional fitness kinds of activities.

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Physician Referrals

Jumping all the way from no. 17 in 2010 and rounding out the top 10 for 2011 is physician referrals, a program associated with ACSM's Exercise is Medicine® initiative. This is a trend toward an emergent emphasis being placed on partnerships with the medical community to facilitate seamless referrals to a health and fitness facility and health and fitness professionals. Physician referrals to fitness professionals first appeared in the top 20 in last year's survey and will find, it seems, additional traction because of ACSM's Exercise is Medicine® initiative and health care reform measures being considered around the world. All four sectors of the health and fitness industry should take advantage of the renewed interest of physicians and the health care insurance industry to add exercise to the daily regimen of their patients and clients.

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Yoga

Yoga has taken on a variety of forms within the past couple of years (including Power yoga, Yogalates, and yoga performed in hot and humid environments). Some of these forms are known as Iyengar yoga, Ashtanga, Bikram yoga (that's the hot and humid one), Vinyasa yoga, Kripalu yoga, Anuara yoga, Kundalini yoga, and Sivananda yoga. Instructional tapes and books are abundant as are numerous certifications in the many yoga formats. Yoga appeared in the top 10 in this survey in 2008 and seems to be making a comeback in the 2010 (no. 14) and 2011 surveys (no. 11).

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Comprehensive Health Promotion Programming at the Worksite

Worksite health promotion programs jumped from no. 20 in last year's survey to no. 12 for 2011 after appearing in the 2009 survey at no. 12. This is a trend toward a range of programs and services provided to improve the health of workers integrated with systems to support the evaluation and reporting of their impact on health, health care costs, and worker productivity. Some of these programs are housed within the corporate building or on their campus. Other programs contract with independent commercial or community-based programs. Within the context of health care reform, health promotion programs may take on additional importance in the future.

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Outcome Measurements

There are now efforts to define and track outcomes as a trend toward accountability to clients in commercial clubs, corporate wellness programs, community-based programs, as well as patients in medical fitness centers. Measurements are necessary to determine the benefits of health and fitness and disease management programs to document success in changing negative lifestyles or the consequences of chronic disease. Today's technology aids in data collection to support these efforts and electronic patient records, and as discussed in recent health care reform measures, may move this trend further along. Outcome measurements have appeared in the top 20 list for all 5 years of this survey.

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Group Personal Training

Falling to no. 14 for 2011 from the top 10 in 2010 is group personal training. This trend allows the personal trainer to still provide the personal service clients expect but now in a small group of two to four, offering discounts for the group. In 2007, group personal training was no. 19 on the list. In 2008, it rose slightly to no. 15 but dropped again in 2009 to no. 19 and finally no. 10 in 2010. In these still arguably challenging economic times when personal income would appear to be decreasing, personal trainers must be more creative in the way they package personal training sessions. Training two or three people at the same time in a small group seems to make good economic sense for both the trainer and the client.

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Spinning (Indoor Cycling)

Staying at no. 15 for 2011 is indoor cycling or spinning. As an instructor explains the terrain and provides the motivation, this group fitness program has been described as pedaling outdoors without temperature, humidity, or other environmental changes. The pedal tension on the stationary bike is like riding uphill or through valleys. Upbeat background music motivates people through this relatively high-intensity workout. Spinning classes have been reported to be one of the most popular group exercise programs in the commercial sector.

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Sport-Specific Training

Falling from a top 10 spot (no. 8) in 2010, sport-specific training dropped to no. 16 for 2011. This trend incorporates sport-specific training, such as baseball and tennis, designed especially for young athletes. For example, a high school athlete might join a commercial or community-based fitness organization to help develop skills during the off-season and to increase strength and endurance specific to that sport. Breaking into the top 10 for the first time in the survey in 2009 (no. 9), sport-specific training jumped from no. 13 in 2008 after falling from no. 11 in 2007. This is an interesting trend for the health/fitness industry to watch over the next few years because of the fall to no. 16 for 2011. It is possible that this trend will attract a new market to commercial clubs as well as offering a different kind of service that could lead to increased revenues.

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Worker Incentive Programs

Appearing for the first time in the survey's top 20 is worker incentive programs. This is a trend toward creating incentive programs to stimulate health behavior change as part of employer-based health promotion programming and health care benefit design. This trend might represent the emerging importance of corporate health promotion programs in an attempt to counter rising health care costs experienced by both small and large companies and corporations. It also may be a response to recent health care reform legislation. Worker incentive programs also may be associated with the trend to provide worksite health promotion programs (no. 12 on the survey) in an attempt to reduce health care costs. There is no mention of where these worker incentive programs take place (perhaps an interesting question for corporate health promotion partners).

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Clinical Integration/Medical Fitness

This is a trend toward the true integration and the blending of prevention and clinical services to the extent that there is no duplication of equipment, facilities, or staff, and services are provided in a shared environment. This is the first time since the inception of this survey that medical fitness made the top 20 list. Interest in medical fitness, worker incentive programs, and worksite wellness programs may be a direct result of health care reform measures and ACSM's Exercise is Medicine® initiative. With these trends in mind, commercial and community-based organizations may want to look for ways to integrate these services into their product lines.

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Reaching New Markets

This is a trend that identifies new markets in all aspects of the health/fitness industry. With an estimated 80% of Americans not having a regular exercise program or a place to exercise, commercial, clinical, corporate, and community programs will reach out to tap into this huge market. Reaching new markets appeared in the top 20 in previous years of this survey but dropped out in 2010. As with some of the other trends already discussed, health and fitness professionals and their employers may be searching for new ways to deliver their services to most people who are still not engaging their services.

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Wellness Coaching

Rounding up the top 20 is wellness coaching, falling from no. 13 in 2010. This is a trend that incorporates behavioral change science into health promotion and disease prevention programs. Wellness coaching often uses a one-on-one approach, similar to a personal trainer, with the coach providing support, guidance, and encouragement. The wellness coach focuses on the client's values, needs, vision, and goals. It appears as though wellness coaching and its techniques of behavior change are being adopted by not only personal trainers, but health care providers as well.

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WHAT'S OUT FOR 2011?

It is always interesting to see what fell out of the top 20 list on this survey for the next year. Particularly surprising was the fall of Pilates from no. 9 (and a top 10 trend for the last 3 years) to not even being in the top 20 for 2011. Pilates is a form of exercise that targets the core of the body (i.e., the abdomen, back, and hips) while using the entire body during a training session. It also increases flexibility and improves posture. The exercises are typically done lying down on a mat and involve a series of controlled movements of the arms and legs that strengthen the abdominal muscles, hips, and back. Pilates first appeared in the top 10 on the survey in 2008 and remained strong through 2010, but disappeared from the top 20 for 2011. A possible explanation is that perhaps Pilates was a fad and not a trend at all.

Also falling out of the top 20 for 2011 was the use of the stability ball and balance training. A stability ball is constructed of rubber with a variable diameter of between 55 and 85 cm (22-34 in.), allowing for a wide range of activities to be performed. The stability ball also is known by other names, including exercise ball, gym ball, Pilates ball, Swiss ball, sports ball, fit or fitness ball, therapy ball, yoga ball, balance ball, or body ball. The stability ball was a surprise in the top 10 for 2008 and 2009 but fell to no. 18 for 2010. This type of exercise did not make the top 20 in 2007, giving some indication that the stability ball may have been a 3-year fad and not a trend at all as predicted in the trend survey for 2010 (4).

The continued interest of the health and fitness industry with specialized exercise programs for the older adult has triggered balance training as a possible trend in past surveys. Activities that promote balance include Tai Chi, yoga, and Pilates, as well as exercise balls, wobble boards, BOSU balls, and foam rollers. In 2007, balance training was not in the top 20 in the trend survey. It first emerged at no. 14 in 2008 and gained strength in 2009 in the no. 10 position. In 2010, balance training not only fell out of the top 10 fitness trends but went to no. 19, and for 2011, it dropped out of the top 20 trends.

A growing trend in the health and fitness industry that is not supported by this survey at all is the use of unmonitored fitness facilities. New fitness franchises are opening that are available to members 24 hours a day. Monitoring is typically available only during "normal work hours," but members can access the facility at any time by using a special keypad that unlocks the door to the facility. Respondents to this survey placed this trend last on the potential list of 31 trends. It received a score of only 5.78 on the scale of 1 to 10. Clearly, health and fitness professionals do not believe that this trend will continue, regardless of the business model and its apparent success in the commercial marketplace.

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SUMMARY

As in the previous four ACSM worldwide trend surveys, some trends were embraced once again (educated and certified health and fitness professionals) whereas others fell out of the top 20, and still others were surprisingly not supported at all (unsupervised and unmonitored fitness facilities). Trends have been defined as a general development that takes some time and then stays for a period (usually described as a behavior change), whereas fads come and go. In the top 10 fitness trends for 2011, six have been on the list the previous 4 years. Falling out of the top 20 for 2011 included balance training, Pilates, and the use of the stability ball. Pilates has fallen the furthest as it was listed as no. 9 in the 2010 survey and no. 7 the previous 2 years. It appears from this survey that Pilates may not have been a trend at all but may be considered a fad in the health and fitness industry. Next year's survey will either embrace Pilates as a trend or will answer this question. ACSM's Exercise is Medicine® initiative continues to climb in the survey as physician referrals climbed to the no. 10 spot in the survey, and for the first time, clinical integration moved into the top 20.

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INTERNATIONAL EXPERTS' COMMENTS ON 2011 TRENDS

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Shinji Sato, Ph.D., Department of Sport and Health Science, Osaka Sangyo University, Osaka, Japan. Professional growth of clinical exercise specialists has been delayed in Japan. The remarkable results reflected in the worldwide survey of fitness trends, "educated and experienced fitness professionals" holding on the top for the last 4 years, indicate the way that should have advanced all over the world. Further education and experience should promote professional growth among our clinical exercise specialists. I believe that this is encapsulated in "Exercise Testing and Prescription," a concept that is embraced throughout the world. In addition, group personal training is an integral part of our training and practice, and it is aimed at facilitating communication between patients with chronic diseases. In 2009, group personal training was ranked no. 19 on the list. In 2010, the rank climbed to no. 10 and then dropped to no. 14 in 2011. We would like to believe that this volatility in the ranking implies that group personal training is a trend and not a fad. The findings of the worldwide survey also indicate that ACSM's Exercise is Medicine® program is a trend that our Japanese physicians should take notice of. We are working toward developing tool kits that will empower clinical exercise specialists, who are the major providers of clinical exercise services in Japan.

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Kathleen Cahill, M.S., RCEP, HealthEnhancements: Medical Education Solutions, President, Clinical Exercise Physiology Association (CEPA is a member of the ACSM Affiliate Societies,www.cepa-acsm.org).The results of this 2011 worldwide survey are quite encouraging for the clinical exercise physiologist (CEP) sector of health and fitness professionals as the value of education/credentialing (no. 1), elderly programming (no. 2), physician referrals (no. 10), outcome measurements (no. 13), and clinical integration (no. 18) ranked in the top 20 trends of the industry. The health and fitness industry ranges from health clubs to clinical programs and requires the collaboration across disciplines to meet the needs of its clients and patients. On the clinical end of the spectrum, CEPs are trained to work with patients with chronic diseases where exercise can be of therapeutic benefit. Understanding the pathophysiology of many chronic diseases allows the CEP to effectively administer exercise therapy in appropriate doses and help patients better manage their disease. With health care reform at the forefront of our nation, CEPs are of invaluable service to physicians seeking qualified professionals to help them manage their patients with chronic disease and measure outcomes. In such situations, clinical integration is a necessary aspect in providing full-spectrum care. Although the results of this survey elucidate the industry's trend toward physician referral and clinical integration, the access of CEPs to patients and physicians must continue to improve through collaborative efforts in legislation and the Exercise is Medicine® initiative. In addition, the importance of accredited degree programs (CAAHEP), certifications (ACSM RCEPTM and CESTM), and an organized profession (Clinical Exercise Physiology Association) must be underscored so that the profession is positioned to respond to future demands in this field.

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Tony Meireles dos Santos, Ph.D., Physical Education Graduate Program, Gama Filho University, Rio de Janeiro, Brazil. The first and most impressive aspect of the fitness trends for 2011 to be pointed out is the consistent importance of the personal aspect of a fitness intervention, observed by the top position of educated and experienced fitness professionals in the past few years. It must include the complete knowledge, skills, and abilities of ACSM's certification program for personal trainers relative to each specific area of intervention and, in general, with a coach's proficiency. Together, this aspect supports the vision of ACSM's initiative to promote fitness and clinical certifications. In complement, the professional assumes a high level of importance in a strategic plan for business success. The second apparent result is the potential of a combination of activities and services relative to functionality and natural or sports patterns of movements. This can be seen by the regular presence of functional fitness, core training, fitness programs for older adults, and similar activities and purposes. Considering it is a low-cost intervention compared with traditional strength training settings, it could be considered as an opportunity for the generation of new markets. Third, the modification of the personal training scenario, including group variations, should be viewed as an opportunity to popularize this service and achieve even higher profits. Finally, the presence of outcome measurements in this list (no. 13) may demonstrate a marketing trend to signalize the revisions of business plans needed to reconnect to the exercise prescription, maybe through coaching strategies.

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Neal I. Pire, M.A., CSCS, FACSM, President, InsPIRE Training Systems, Ridgewood, NJ.I am not surprised to see boot camps climbing into the no. 8 spot in the survey. Boot camp programs are one of the fastest growing trends in fitness. Part of the reason might be that it is a spin-off from small-group personal training, which has made the top 20 in the survey during the past few years. The economy has been a driving force in group fitness programming growth. In response to the tightening economy, some trainers have reduced their fees, whereas many others have reinvented themselves and have started training groups at reduced cost per participant. This has lowered the barrier of entry for the participant while actually increasing the income potential for the trainer. Some trainers have become licensed boot camp franchisees, whereas others have innovated to differentiate their boot camp programs from the traditional "Paris Island" experience to more niche-oriented programs (Bridal Boot Camp for brides-to-be, or Baby-Boomer Boot Camp for the 50+ participant). Two areas that I am surprised not to see in the top 20 include high-intensity, quick-fix fitness programs (i.e., Cross-Fit, PX-90, Insanity, The 300 Workout); each workout regimen might be considered a fad on its own, but the category seems to be a trend - high-intensity metabolic training protocols that promise extraordinary results in a relatively short and definitive period. The other area is the no- to low-frills facility, which includes the unstaffed 24-hour access facility (i.e., Anytime Fitness, Snap Fitness) and the large low-monthly-dues membership facilities (i.e., Planet Fitness, Retro Fitness). These are options for the seasoned exerciser while also providing fee-for-service personal training for the rookie member.

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Acknowledgments

The author thanks Editor-in-Chief Ed Howley, Ph.D., FACSM, for considering this project important enough to include in the year-end edition of ACSM's Health & Fitness Journal®. The author also thanks the ACSM's Health & Fitness Journal® editorial team, especially those who contributed to the original survey in 2007, Paul Couzelis, Ph.D.; John Jakicic, Ph.D., FACSM; Nico Pronk, Ph.D., FACSM; Mike Spezzano, M.S.; Neal Pire, M.A., FACSM; Jim Peterson, Ph.D., FACSM; Melinda Manore, Ph.D., R.D., FACSM; Cary Wing, Ed.D.; Reed Humphrey, Ph.D., P.T., FACSM; and Steve Tharrett, M.S., for their very important input into the construction of the original and subsequent surveys. Finally, the author is indebted to the ACSM staff that supported this study by assisting in the construction, formatting, and delivery of it to thousands of fitness professionals around the world. In particular, the author recognizes the important contributions of Dick Cotton, Traci Rush, Kela Thomas, and especially Lori Tish.

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CONDENSED VERSION AND BOTTOM LINE

The 2011 worldwide survey of fitness trends is now in its fifth year. It assists the health and fitness industry make critical programming and business decisions. The results are applicable to all four sectors of the health and fitness industry - commercial, clinical, corporate, and community fitness programs. Although no one can accurately predict the future because of the uncertain economy all over the world, this survey helps track trends in the field that will assist owners, operators, program directors, and personal trainers make important business decisions.

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References

1. Thompson, WR. Worldwide survey reveals fitness trends for 2007. ACSM's Health & Fitness Journal. 2006;10(6):8-14.
2. Thompson, WR. Worldwide survey reveals fitness trends for 2008. ACSM's Health & Fitness Journal. 2007;11(6):7-13.
3. Thompson, WR. Worldwide survey reveals fitness trends for 2009. ACSM's Health & Fitness Journal. 2008;12(6):7-14.
4. Thompson, WR. Worldwide survey reveals fitness trends for 2010. ACSM's Health & Fitness Journal. 2009;13(6):9-16.
5. Quickly growing major, inside higher education, August 11, 2010 [cited August 13, 2010]. Available from: http://www.insidehighered.com/news/2010/08/11/kinesiology.
Keywords:

Commercial; Clinical; Corporate; Community; Future Programs

© 2010 American College of Sports Medicine.