Program Design for Mobility, Balance, and Strength
What the exam tests
This domain tests FITT-VP decisions for mobility, balance, and strength: exercise selection, order, dosage, and progression for older adults, including frail and deconditioned clients.
Core rules
- Strength: 2–3 nonconsecutive days per week; 1–3 sets of 8–12 reps at roughly 60–70% 1RM for novices; prioritize hip extensors and abductors, knee extensors, ankle dorsiflexors, plantar flexors, and trunk.
- Power: 1–3 sets of 6–10 reps at 40–60% 1RM moved as fast as safely controlled. Power predicts falls and functional independence better than maximal strength.
- Balance: progress static to dynamic, firm to compliant surface, wide to narrow base, eyes open to closed, single-task to dual-task. Train 2–3 days per week, challenging but supported.
- Mobility: dynamic warm-up before training; static holds of 30–60 seconds after training or in separate sessions; target ankles, hips, thoracic spine, and shoulders.
- Order: warm-up, balance, strength, power, cool-down.
- Progression: change one variable at a time, about 5–10%, when the client completes prescribed reps with good form and RPE at or below 13.
Worked example
A 78-year-old woman who uses a cane and reports fear of falling trains twice weekly. Warm-up 8 minutes. Balance 10 minutes: tandem stance 3 × 30 seconds with counter support, single-leg stance 3 × 10 seconds each side, obstacle stepping, and dual-task counting backward. Strength: sit-to-stand 2 × 10, step-ups 2 × 8, heel raises 2 × 12, seated row 2 × 10. Power: 2 × 6 fast sit-to-stands. Cool-down. Reasoning: balance comes before strength while attention and safety are highest, power is included because it best predicts fall risk, and volume stays low enough to protect recovery. Progress hold times first, then load.
Traps that cost marks
- Static stretching immediately before balance work.
- Machine-only programs that omit standing and transitional movements.
- Omitting power training.
- Advancing load and complexity in the same week.
- Never adding head turns, dual tasks, or reactive steps.