Client Assessment and Program Design
Domain 3: Client Assessment and Program Design
This domain tests a repeatable process: intake, screening, observation, movement assessment, goal setting, session design, and reassessment. The exam rewards designs that follow from the client's presentation, not from a favorite routine.
Core rules and concepts
- Start with health history, informed consent, activity level, goals, and red flags. Use a standard tool such as PAR-Q+ or an equivalent clearance process, and follow your scope when interpreting answers.
- Assess posture and movement in standing, sitting, supine, and transitional tasks. Look at alignment, breath, spinal articulation, single-leg control, and tolerance for flexion, extension, rotation, and loading.
- Write goals that are specific and measurable, then choose exercises by intent: mobility, stability, strength, endurance, balance, or skill.
- Progress one variable at a time: range, lever length, spring load, speed, complexity, or support. Regress by adding support, shortening the lever, or reducing range.
- Reassess at planned intervals and document changes.
Worked example
A new client has low bone density, a kyphotic thoracic posture, and wants strong abs. Reasoning: loaded end-range spinal flexion and rotation are higher-risk choices; the program should prioritize thoracic extension, hip hinge, neutral-spine strength, balance, and upright control. Start with supported thoracic extension over a spine corrector, a hip hinge, and a short-range abdominal isometric. Avoid a full Roll Up and loaded twisting until clearance and tolerance are established.
Traps that cost marks
- Designing from the repertoire rather than from the assessment.
- Ignoring red flags such as night pain, unexplained weight loss, neurological symptoms, or chest pain.
- Progressing load before control.
- Applying one template to every client, especially with osteoporosis, pregnancy, or acute low back pain.