The 19th annual ACSM Health & Fitness Summit & Expo, held March 31–April 3 in Phoenix, AZ, was another great success for ACSM. The event brought together nearly 1,000 health and fitness professionals, expert presenters, and industry companies to explore the full spectrum of the industry — from science to practical application. Through three informative and inspiring keynotes, 59 lectures, 14 interactive workshops, 30 master class workouts, three “Hot Topic” panel discussions, 6 preconference events, and a number of special sessions, attendees learned the latest exercise and wellness applications grounded in sound scientific research, strengthened their knowledge and skills, saw the latest products in the exhibit hall, and found opportunities to meet and network with colleagues. It all added up to a rewarding and enjoyable experience with attendees returning home not only with 25 new continuing education credits for attending the Summit but also invigorated and ready to put new ideas to work.
The Summit’s mission since its beginning in 1997 has been to “bridge the gap” between the science of sports medicine and the practice of health and fitness by having faculty focus presentations on the practical applications of the latest research. Presenters are instructed to provide at least three take-home learnings to be applied in everyday situations in fitness centers, clubs, schools, corporations, and other community organizations. There was something for everyone, as sessions were offered in 10 programming tracks:
- Exercise Programming
- Fitness Management and Communication
- Healthy Behavioral Change and Motivation
- Personal Training
- Alternative Health and Wellness
- Select Populations
- Social Media and Technology
- Sports Medicine
- Worksite Health Promotion
The host Hyatt Regency Phoenix Hotel and Phoenix Convention Center did a fine job of keeping things running smoothly, accommodating the needs of all those present and welcoming us with some warm southwestern hospitality (and weather!). This report offers a glimpse of the conference as seen by members of ACSM’s Health & Fitness Journal® Editorial Board and conference planning committee members. It includes summaries of two keynote addresses, including the inaugural Larry Golding Lecture, select lectures and workshops, the annual Dr. Walter Bortz Lecture on Healthy Aging, and other special sessions and conference features.
Before the opening keynote on the first day of the Summit, six half- or full-day extended workshops on specialized topics were offered, and 300 attendees took advantage of these unique learning experiences. In addition to the event summarized below, sessions offered were “The Exercise Professional’s Ultimate Tool Kit,” “Energy Balance and Weight Management,” “Trigger Point Foam Rolling Principles and Practices,” “BOSU 3D XTREME Certification,” and “Worksite Health Promotion: Enhancing Your Impact, Expanding Your Reach.”
CLINICALLY ORIENTED FIELD ASSESSMENTS: THEIR THEORY AND APPLICATION TO YOUR CLIENTS — Peter Ronai, Christian Thompson, Benjamin Thompson, Steve Bliven
The faculty began the session by discussing the theory behind several clinically relevant field-based physical assessments before practicing them in small groups. The goal was to help attendees learn how to apply qualitative and quantitative observations from each assessment to develop safe, effective, and clinically meaningful exercise programs for clients. Christian Thompson reviewed and demonstrated a number of functional assessments for determining client movement, competency, balance, physical fitness and function, and the risk of falls in older adults. Tests included the Berg Balance Test, Gait Speed test, Rikli and Jones Senior Fitness Test protocol, and others. Peter Ronai demonstrated a number of field assessments of alignment, musculoskeletal function, and movement quality. Attendees practiced the Wall Stretch, Trunk Flexor, Trunk Extensor, McKenzie Extension, and other tests. Steve Blivin reviewed a number of preexercise special assessments of cardiovascular, neuromuscular, and musculoskeletal system health. A physician, Dr. Bliven shared several examples of how health care providers and fitness professionals can work together to improve client outcomes. Participants learned how to identify basic electrocardiographic patterns and common arrhythmias that can occur in exercise settings. He also demonstrated exercises for improving strength, balance, and mobility and had participants perform several basic movement assessments of flexibility and strength. Ben Thompson, current chairman of the ACSM Certified Exercise Physiologist (EP-C) certification committee, discussed the theory behind several simple yet meaningful cardiovascular and anthropometric techniques. Test administration protocol for the 6-Minute Walk test, the Queen’s College Step Test, and other cardiovascular field tests was demonstrated and practiced. Participants learned how to administer a number of anthropometric measurements and compared and contrasted their reliability and validity with specific populations. From measurements like waist and hip circumferences, Thompson showed how to calculate fat and lean weight and to determine ideal weight. In addition, he taught participants how to use step test equations to predict aerobic capacity. Take-home messages were as follows:
- Clients must be cleared medically by their physician or health care provider before testing.
- Certified exercise professionals must work within their scope of practice during testing.
- Field-based assessments should be valid tools that facilitate the development of safe, effective, and individualized exercise programs.
- Results from field assessments can facilitate communication between exercise professionals, clients, and their physicians and health care providers.
OPENING KEYNOTE — Steve Shenbaum
The Summit got off to a rousing start with Steve Shenbaum’s keynote on “Building Authentic Connections with Clients.” Steve is founder and CEO of Game On Nation and is a leading expert in the use of game dynamics to improve communication. In Steve’s hilarious and insightful session, he took the audience through a series of games to teach how to connect with clients in a fun and meaningful way. In “1-2-3,” two people partnered up and began taking turns each saying a number until they counted to three for a certain amount of time. Easy enough, right? Except that a two-person exchange adapting to a pattern of three results in lots of confusion and laughter and connection. If fitness pros want to connect with clients, listening and building relationships and trust are good places to start. People connect with and listen to those they like and respect. Another game Shenbaum shared was called “Coins,” a fun way to help people remember topics about themselves they are comfortable sharing to fuel conversations with genuine enthusiasm and connect with others in a sincere way. “Coins” give one the opportunity to recognize and place value on personal qualities, goals, hobbies, and interests. A “coin” could be anything that has meaning to someone, no matter how big or small, and it lights them up just by thinking about it. For many, talking about their job is a comfortable “coin” but it also can be overdone, so using another “coin” can help build connections. Take-home messages:
- Listen, Don’t Wait to Talk. Be present and available to those you are engaged with, listen and respond to what is said rather than just waiting to say something.
- Don’t Be Too Cool for School. Remember when you were 7 years old and had no ego, no judgment, no worries, and just wanted to play? Get back to that self and let go of the things that keep you distant from others.
- A Genuine Smile Is Money. When you think about your “coins,” allow yourself to light up with a smile.
- Be a Coin Collector. There are “coins” in your pocket that may not come up in conversation; don’t force using them but rather listen for other people’s coins and take an interest in them.
HONORING DR. GOLDING
Of special note at this year’s Summit was the Inaugural “Larry Golding Lecture” honoring Dr. Lawrence A. Golding, Ph.D., FACSM, a leading force behind the development of the Summit, ACSM’s Health & Fitness Journal®, and ACSM’s Alliance of Health and Fitness Professionals membership. Featured in an article in the March/April 2015 issue of the Journal, Dr. Golding served as chair of the Summit for the first 12 years of its existence and editor-in-chief of Journal for its first 8 years. A 60-year educator at the University of Nevada, Las Vegas (UNLV), and Kent State University, Ohio, Dr. Golding has been a vocal proponent of the health/fitness practitioner, going back to his early work with the YMCA to develop a standardized fitness field test protocol and normative database, first published in “The Y’s Way to Physical Fitness” in 1973. That protocol of the bicycle ergometer, sit and reach, skinfolds, and sit-up tests has been taught in schools and organizations around the world and became for many years the industry’s standard fitness testing battery. In addition, Larry did not just teach college courses, he led a group exercise class for the community on the UNLV campus during his tenure there.
Before the Golding Lecture, the 2015 recipients of the Lawrence A. Golding Scholarships were announced. Offered for the 10th year, the scholarship recognizes undergraduate students who are in their sophomore, junior, or senior year and have made significant contributions to their communities in the areas of health, fitness, or education. Winners receive $1,000 from ACSM, $1,000 credit for products from the Healthy LearningTM ACSM store, and complimentary registration to the Summit. This year’s winners were Natalie Eichner from the University of Virginia, Charlottesville, and David Niehaus from Sandhills Community College, Pinehurst, NC.
CLOSING KEYNOTE, THE INAUGURAL LARRY GOLDING LECTURE — Carol Ewing Garber
Dr. Garber currently is president of ACSM and the lead author of the ACSM Position Stand entitled “Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory, Musculoskeletal, and Neuromotor Fitness in Apparently Healthy Adults: Guidance for Prescribing Exercise.” She stated that physical inactivity has become the most important public health issue of our time and that concerted efforts are needed to prescribe the right dose of exercise to combat this growing pandemic. Dr. Garber provided an evidence-based review of exercise prescription guidelines and discussed current controversies related to the potential benefits of high-intensity interval training, the role of pre-event static stretching, and the risks of exercise training. The presentation also highlighted the potential value of less intense bouts of physical activity as well as the importance of neuromotor exercises such as tai chi and yoga. Take-home messages:
- Individualizing the exercise prescription based on personal goals, health history, and training status can facilitate the adoption and maintenance of the exercise program.
- Although there is a “menu” of approaches for safe and health-promoting exercise, the exercise prescription should be based on the latest scientific evidence and consistent with individual needs, goals, and abilities.
- Qualified health and fitness professionals are on the forefront of the “battle on physical inactivity” and have tools in their armamentarium to develop individualized exercise programs that enhance the health and well-being of their clients.
More than 70 1-hour lectures and 1.5-hour interactive workshops took place during the course of 3 days packed with learning, led by some of the industry’s top presenters and authorities. Because most sessions were held twice, attendees had the opportunity to take in as many as possible. Still, there were so many “must-see” offerings that deciding which to attend was often challenging. Here is a small sample of what was offered:
Live Long and Prosper! Giving Older Adults the Gift of Fitness: The Dr. Bortz Lecture on Healthy Aging — Christian Thompson
Thompson recognized the extraordinary contributions of Walter Bortz, M.D., to medicine and exercise for older adults and the foundations of healthy aging. Dr. Bortz’s books, “Dare to Be 100” and “We Live Too Short and Die Too Long,” have emphasized the importance of regular physical activity and a prudent diet as they relate to longevity and health-related quality of life. Thompson described the relationships between nutritional intake and exercise and disease prevention and management and longevity. He also provided practical examples of ways clients can adopt lifestyles associated with healthy aging. The presentation included a review of literature supporting the positive effects that a healthy diet and regular physical activity have on longevity, risks of falls, and health-related quality of life. Results from both contemporary randomized control trials on nutrition and exercise and classic epidemiologic studies of Harvard Alumni, London bus conductors, elderly strength trained, and endurance-trained individuals all indicate how important it is that elderly and younger persons eat a prudent diet, perform strength training and endurance training exercises, and increase their non–exercise-associated physical activities. Take-home messages:
- Age is not a disease, it is a process and it needs a different paradigm.
- When young, exercise is recommended; when old, exercise is IMPERATIVE!
- Exercise. Just do it. In really, really small increments.
Bonus: It’s never too late to start; it’s always too soon to stop!
ACSM’s American Fitness Index: From Evolution to Revolution — Walt Thompson
Funded by the Anthem Foundation, ACSM’s American Fitness Index® (AFI) combines the personal health status of a city’s population, which includes preventive health behaviors and levels of chronic disease conditions, with community assets that support healthy lifestyles like support systems, the built environment, and policies for physical activity. The results are then ranked for the 50 most populated cities in the United States, creating an annual index. The AFI is an effective measure that captures the state of personal health, community fitness program availability, and local grassroots advocacy efforts. Because the AFI is scientific and evidence based, it is unique among various health indices. The AFI report has been released every year since 2008, along with technical assistance for cities wanting to improve their ranking. Take-home messages to affect community change:
- Be a role model for good health and physical activity.
- Volunteer your expertise by joining a local coalition dedicated to encouraging physical activity.
- Educate community leaders and bring awareness to the physical inactivity epidemic.
- Advocate that community leaders take a proactive approach to solving activity challenges.
Eating Behaviors: Why and How You Eat Are More Important Than What? — Kara Mohr
Dr. Mohr discussed the ways eating behaviors influence calorie intake and affect weight management. Specifically, she highlighted ways hunger, cravings, and mindless eating can lead to excess calories. She discussed tips for how to teach clients to manage cravings and reduce the occurrence of cravings in the future. Dr. Mohr also described the importance of knowing habit chains and habit loops in understanding behavior. By helping clients identify and change the antecedents and consequences surrounding behaviors, health fitness professionals can help clients make lasting behavior change. Take-home messages:
- Teach clients to recognize the triggers that cause them to want to eat (when not truly hungry) as an important first step in changing eating behaviors.
- There are a multitude of environmental influences that affect energy intake. Simple shifts in environmental cues can lead to a significant reduction in calorie intake.
- A habit loop consists of a cue, a behavior, and a reward. By altering the cue or reward, new habits can be formed.
The Power of One: Slow Change Theory — Krista Scott-Dixon
Scott-Dixon stated that when clients don’t change behaviors, it is almost NEVER about not having enough information. They know what they should be doing but not how to make that habit stick. Using slow change theory and the power of one habit at a time, Scott-Dixon discussed ways to help clients change permanently, first by observing, understanding, and clarifying client priorities. The next step is to develop strategies in collaboration with clients, choosing only one thing to work on at a time. Clients need to be confident so that they can manage the change they picked. If not, help them shrink the amount of change until they are confident, master that behavior, and then move on to a new one. The key is that the most lasting type of change is slow change, with client buy-in. Take-home messages:
- Ambivalence is a natural part of any change process.
- Behavioral and environmental modifications trump willpower and motivation.
- A client-centered, habit-focused, slow-change approach can change habits effectively long-term and is a good strategy to overcoming resistance and ambivalence in clients.
FUNdamental Integrative Training for Kids: Play On! — Avery Faigenbaum
Dr. Faigenbaum highlighted the growing need to identify physically inactive youth early in life and target them with developmentally appropriate interventions before they engage in unhealthy behaviors. He described a method of conditioning called FUNdamental Integrative Training (FIT), which incorporates both health- and skill-related components of physical fitness into every lesson. Current research indicates that regular participation in FIT can enhance muscular fitness, improve aerobic endurance, and develop fundamental movement skills. Health and fitness professionals are in a desirable position to develop youth programs that enhance physical fitness, foster social networks, and promote healthy behaviors in a supportive environment. Take-home messages:
- Youth fitness programs that integrate health- and skill-related components of physical fitness can help participants acquiring the muscular strength and motor skills needed to support an active lifestyle.
- Creative strategies are needed to increase daily physical activity among school-aged youth and spark an ongoing interest in active games, fitness recreation, and sport.
- FUNdamental Integrative Training can provide children and adolescents with an opportunity to have fun while gaining competence and confidence in their physical abilities.
Movement Analysis in Older Adults — Christian Thompson
Thompson provided an excellent overview of the need for movement analysis in older adult populations caused by risk of falling. He reviewed the rationale behind the Timed Up and Go (TUG) test as a simple field measure, including information necessary for evaluating movement quality and the use of a scoring system to aid in exercise program design. Also discussed were various functional elements associated with different task demands and how actions are connected with systems, that is, a cone turn or turn to sit requires that one has adequate vestibular function and dynamic balance. He showed that exercise regressions and progressions based on TUG scores connected the clinical assessment with practical strategies to improve movement quality. Recommendations based on quartile scores suggested moving from “most regressed” to a third level of exercise progressions for joint mobility, strength, balance, and enhancement of gait and sensory responses. Take-home messages:
- Older adults can benefit from objective metrics, such as the TUG test, to assess movement quality on a regular basis. The TUG test can screen for subtle changes associated with the aging process and provide early identification of the need for corrective exercises or medical referral.
- Individuals working with older adults should be familiar with a number of different strategies to regress and progress exercises to improve joint mobility, strength, gait, balance, and sensory responses during movement.
Partnering With Health Care Providers for Outcome-Based Exercise Programming — Michael Spezzano
This session reviewed the development of partnerships between health fitness centers and health care organizations to build new medically integrated models of delivering outcome-based exercise and health programs. Collaborating with health care providers allows fitness facilities to expand their continuum of services to include medical fitness programming and as well as codevelop state-of-the-art medically integrated wellness facilities. Using a model medical wellness center developed in Des Moines, IA, by Mercy Hospital and the local YMCA as an example, he showed how fitness centers aligning with hospitals can leverage clinical outpatient programming and develop outcome-based exercise programs. Credibility with health care providers is needed to establish a referral network for patients to become program participants and members. Working together, health care providers and fitness facilities can develop innovative solutions that will enhance a fitness center’s ability to work with people with lifestyle disease and other medical conditions, such as diabetes exercise, cancer wellness, and pain management. Featured in the presentation was an exercise program for people with diabetes by MoveWell Today?. Spezzano shared data from 95 participants in a 12-week circuit training program that showed a 6% decrease in HbA1c counts, a 3.2% decrease in body weight, and more than 35% improvements in three senior fitness test scores. Take-home messages:
- Make sure staff have proper levels of training, education, and professional certification.
- Building effective physician referral networks for medical wellness programs by communicating regularly with health care providers.
- Conduct outcome-based medical exercise programs, such as the diabetes exercise program profiled, and share program data with health care providers.
How to Train the CORE FOUR: The Secrets of Stability and Function — Peter Ronai
The session began with the speaker asking attendees to identify common compensatory movements and patterns that occur during the exercise performance that can indicate the presence of muscle imbalances and the potential for developing specific movement dysfunctions. Dr. Ronai showed attendees how to teach clients a number of supplementary exercises requiring minimal equipment, space, and time that can help improve movement competency and joint stability and function and help prevent injuries. Attendees also performed exercises designed to enhance muscle strength and function within the “CORE FOUR” regions discussed during the workshop: the neck, shoulder girdle, hips, and low back. They also learned specific exercises to enhance strength and function in less active muscles and how to modify, regress, and progress basic exercises. Finally, fundamental tasks and skills requiring body segmental control, stability, movement competency, proficiency, and muscle strength and endurance were reviewed. Take-home messages:
- Performance of some “advanced-type” workout protocols challenge and can exceed many client’s movement competency, proficiency, strength, and joint stability.
- Assessment of client’s movement competency and the presence or absence of typical postural imbalances and compensatory movement strategies can help direct supplementary exercise selection and should precede participation in advanced or higher-intensity workout protocols.
- Exercises using minimal equipment can enhance multisegmental stability and function, enhance movement competency and proficiency and muscle function, and help prevent injuries.
As if there wasn’t enough for attendees to do, the Planning Committee included a number of special panel presentations throughout the Summit’s daily schedule to enhance the conference experience. One popular panel session was High-Intensity Training: The Good, the Bad, and the ?s — Mike Bracko, Steve Blivin, Dixie Stanforth.
The goal of this panel session was to provide a balanced evaluation of the current research and controversies surrounding extreme conditioning (ECP) and high-intensity interval training (HIIT) programs. The literature currently does not define clearly what these terms mean, leading to confusion within the fitness community. Bracko reviewed some of the research supporting the value and efficacy of HIIT in a wide range of populations including not only improved aerobic capacity but also exercise tolerance and markers of disease risk. Blivin noted that the incidence of injury with ECP is similar to other forms of vigorous exercise, yet also provided anecdotal reports of rhabdomyolysis within the military setting to explain the heightened concerns. His recommendation was for trainers to understand and work to mitigate the risks of vigorous exercise, regardless of type and matched to population. Questions and comments from the audience ranged from concerns regarding adequate regression strategies to a call for the need to develop interval training recommendations (both time and workload/intensity) for select populations. Take-home messages:
- HIIT appears to be a valid training modality with potential health and fitness benefits for a wide variety of populations. Vigorous exercise may be contraindicated for certain individuals, and instructors should be aware of both risks and benefits.
- “High intensity” is a relative term: match intervals to individuals and select populations when developing programming.
- One recent article attempting to define the terminology is noteworthy: Weston, K.S., U. Wisloff, and J.S. Coombes. High-intensity interval training in patients with lifestyle-induced cardiometabolic disease: a systematic review and meta-analysis. Br J Sports Med. 2014;48:1227–34.
MASTER CLASS WORKOUTS
These popular Summit sessions are more than just workouts; they are educational experiences for attendees to learn practical tools from leading industry presenters like Abbie Appel, Shannon Fable, Fred Hoffman, June Kahn, Alex McLean, and Carol Murphy that will enhance exercise programs or personal training businesses back home. In these sessions, faculty demonstrate exercise techniques, new workout protocols, and the latest equipment, as well as share teaching tips to improve training and instruction skills. The 2015 Summit offered more workouts than ever, with 30 sessions like HIIT Blitz, The Art of Mind-Body Fusion Training, Powerful Teaching Dance-Inspired Cardio, Bodyweight Bootcamp, Ripped and Whipped Trampoline Circuit, and 101 Ways to BOSU!
After the Opening Keynote on Tuesday evening, the Exhibit Hall opened with a lively reception for all attendees. Featured were light refreshments, music, networking, and raffles for free gifts as attendees perused the booths of the 31 vendors and Summit sponsors showcasing the latest products and services. The hall remained open all day Wednesday and until 2 p.m. Thursday, so there was plenty of opportunity to return again and again.
THE 2015 ACSM SUMMIT 5K RUN AND WALK SPONSORED BY PROPEL
A total of 92 conference attendees participated in the annual Summit 5K run and walk held in nearby Papago Park, 10 minutes from downtown Phoenix. Bussed from the Hyatt at 6 a.m., enthusiasts had a unique opportunity to see massive sandstone buttes and Sonoran Desert habitat along a smooth flat 5K course. Propel provided t-shirts and hydration products to all participants in this free Summit event.
Across the years, a growing number of college students have attended the Summit to enhance their learning, network with those in the industry, and explore future career options. A special mention must be made of long-time Summit supporter Penn State University (PSU). For many years, PSU has sent many faculty and students who use the Summit experience as part of college coursework for credit. This year, a group of 43 students and 4 faculty from PSU were in attendance. Overall, a total of 160 students attended the Summit, including 10 from Arizona State University, 8 from Mesa Community College, and 8 from the University of Pittsburgh.
The next ACSM Health & Fitness Summit & Expo will be the 20th annual event and is scheduled for March 29–April 1, 2016, in Orlando, FL, at the Hilton Orlando Lake Buena Vista in Disney World. To register, visit www.acsmsummit.org. For those who attended the 2015 event, thank you for joining us and supporting ACSM. For those who missed it, please accept this invitation to join us in 2016.
Select Summit presentations are available online for CEC credit from ACSM at: www.onlinelearning-acsm.org.
Thanks to Dr. Avery Faigenbaum, Dr. Kara Mohr, Peter Ronai, Dr. Dixie Stanforth, and Dr. Walt Thompson for serving as contributing reporters during ACSM’s Summit and assisting with this article.