the quality of health clubs
In the past ten years, health clubs began to offer the best facilities and equipment for the exerciser. New and improved equipment arrives almost monthly, and new or improved programs become available regularly. There has been some concern lately that program design and staff members’ qualifications are exclusively focused on the already fit. Individuals not already capable of “leaping tall buildings at a single bound” felt somewhat out of place at many health clubs.
In the face of an aging population and the emerging tendency of health clubs to enroll patients after the conclusion of heart disease rehabilitation programs, the perceived lack of focus on less athletic consumers has led to concern regarding the safety, programming and staffing of health clubs.
Furthering this concern, recent surveys have demonstrated generally inadequate pre-exercise screening and safety programs in a high percentage of health clubs, even the so-called “quality” clubs.
Beginning with “How to Choose a Health Club” from the New York Affiliate of the American Heart Association in 1985, various professional groups have worked to address those concerns. “How to Choose a Health Club” from the Wisconsin Affiliate of the American Heart Association added suggestions regarding “right” answers to consumers’ questions. The American College of Sports Medicine (ACSM) published an updated hardcover book “Health/Fitness Facility Standards and Guidelines,” in 1997.

ACSM Current Comment
Pais an important way to reduce the risk of a variety of degenerative diseases. It is comparable in magnitude of importance, but opposite in direction, to smoking, high blood pressure, elevated blood cholesterol levels, and diabetes. Scientific data supporting the health value of exercise is compelling enough that a wide variety of health agencies including the American College of Sports Medicine, the American Heart Association, the Centers for Disease Control and Prevention, the National Institutes of Health, and the Surgeon General of the United States have issued pronouncements regarding the health benefits of exercise.

Exercise in Health Clubs
An ACSM Report
Health clubs are specialized facilities designed to allow and have access to a variety of specialized participants to exercise in a stimulating environment cialized equipment and programs. These facilities are important to persons who want to achieve their exercise goals. The role of such facilities dates back at least to the 19th century.

Exercise in Health Clubs
1) All participants should be screened before participation. The idea is to risk-stratify participants by identifying those individuals who should be directed toward their health-care provider before participating in exercise. Further, this provides an avenue for maintaining a dialogue with the personal health-care provider of participants who might be less than totally healthy. The AHA-ACSM document provides a useful tool for appropriately directing participants to facilities with the staffing and programs to suit even special needs. However, the public health benefits of exercise are so large that there is wide agreement that any screening process should not be so intensive that it serves to discourage participation. Simple questionnaires such as the PAR-Q (developed in
Canada) or one developed by AHA can identify within only a few moments problems that might contraindicate exercise. At the lowest level, such as clubs with no professional staff or the exercise rooms available in many better hotels, screening can be accomplished with signage.
2) All health clubs should have an appropriate emergency plan. This may be as simple as a phone with appropriate signage directing the caller in unsupervised exercise rooms, to very complex plans including a full crash cart and defibrillator in facilities providing for clinically fragile populations. In any case, the emergency plan should be well thought-out, written, and practiced with enough regularity to ensure that it works well when needed.
3) In health clubs that have professional staff, the staff should have demonstrable professional qualifications such as a degree in exercise science (or equivalent) or certification by a nationally recognized professional society on the basis of a competency-based examination.
The level of staff qualifications will vary significantly, depending on the type of participant accepted by the facility. Particularly in facilities that offer programs designed to appeal to older participants or to participants with known health problems, the staff should have special qualifications, usually an advanced, clinically oriented certification from a nationally recognized profession facilities, other health care providers with specialized clinical skills may frequently be involved in formulating the exercise plan. It goes almost without saying that all professional staff (and perhaps every staff member in the facility) should have CPR certification so they can respond quickly to emergency situations.