Six Sigma Fitness?? Overview

Six Sigma

Six Sigma started as an internationally recognized statistics-based methodology of techniques and tools for process improvement to eliminate defects from any manufactured product or service, but it has evolved into an agnostic approach utilizing highly customized Tools to solve problems in every sector of our society.

In statistics, the Greek letter “S” (sigma) is a measure of?variation. In business, Six Sigma is a measure of quality: 3.4 defects per one million events, with a “defect” defined as a variation from the desired outcome. In any process or system, 3.4 defects per million referred to as “Six Sigma” is an extremely low rate of error and an ideal theoretical target. (One sigma would create variations in 70% of the outcomes)

At Six Sigma Fitness?? we view the body as the ultimate manufacturing machine. The human body creates energy, movement, and thoughts to allow you to optimize your human performance. It manufactures physical products like hair and skin, muscle tissue or bones just to name a few. Sometimes against our wishes it creates fat. Although the production of fat is a normal human process, too much fat and in places we don't want it represents a variation in the process that leads to poor results. It is the ability to manufacture so many different things including fat that also keeps us alive and well but it is the irregular variations in these processes that Six Sigma attempts to identify and solve.

Our organs and cells are constantly regenerating. We manufacture cortisol, epinephrine and norepinephrine for high intensity energy (anaerobic) for fight or flight as a protective mechanism and low energy (aerobic) to allow us to work for our food all day. If we produce to much of either we become ill or unhealthy. We manufacture all types of chemicals and hormones to regulate our homeostasis to keep us healthy. Homeostasis must stay within a narrow band or range of control to keep us healthy and optimized. Variations in homeostasis represent errors or defects we need to monitor to get back on track. Our body temperature, our blood pressure, heartrate and breathing all represent vital signs that can be monitored and kept within a narrow band of acceptable norms for optimal health. Our immune system manufactures antibodies to keep us from getting sick. An over-response from the immune system can kill us. Human bodies manufacture products 24/7 and human bodies produce errors or defects in all of these processes often caused by our own habits and environment. It is the variation in these processes that Six Sigma is trying to control and keep to an ideal theoretical minimum, the prefect functioning human. A Six Sigma human.

Six Sigma Fitness??

Six Sigma Fitness?? is a Framework of Methodologies that utilizes Tools, Practices and Processes to improve the quality of human health, wellness and performance. It utilizes an internationally recognized DMAIC Framework approach to Define, Measure, Analyze, Improve and Control human defects that stop us from optimizing our physical and mental potential. The Framework gives us a broad agnostic system to organize, structure, share and improve health data.

Everything within the Six Sigma Fitness?? system falls within the 5 phases of DMAIC (the Framework). Each phase of DMAIC contains Methodologies to apply during that phase. Each Methodology utilizes Tools, Practices and Processes in the application of the methods used. This is the Hierarchy and taxonomy of the Six Sigma Fitness system.

Six Sigma is a widely recognized statistical process that measures defects, errors and weaknesses in the manufacturing, development or delivery of a product or service. Six Sigma Fitness identifies human defects such as weight gain, fatigue, poor metabolism, weakness, depression, irregular biomarkers... and attempts to reduce or eliminate as many as possible through this proven problem solving methodology. In theory it is a data driven process to become defect free by attaining a statistical defect or error rating of “six sigma” so that 99.99966% of your human performance is functioning optimally.

We may never reach this theoretical standard, but we don’t need to in order to live a long healthy life. Six Sigma is the metaphorical goal we strive for. We use the methods and tools of Six Sigma through the DMAIC process to gather data and address solutions to your most important health issues.

Framework

DMAIC is the overall umbrella Framework under which all aspects of the Six Sigma Fitness?? system are organized and applied. It dictates the Client journey and categorizes the steps in the process. It is applied in a similar approach as a medical differential diagnosis, but as most health Practitioners, Clinicians, Coaches, Trainers and Instructors may not be licensed in Health Care specifically, we utilize a different taxonomy and sub-clinical methods.

DMAIC

• Define -What is important?
• Measure – How are we doing?
• Analyze – What is wrong?
• Improve – What needs to be done?
• Control – How do we ensure success?

A typical DMAIC process is summarized using DMAIC Applied Implementation at the end of this article below.

Methodology Matrix

The Define, Measure and Analyze phases of DMAIC are implemented through a series of Methodologies that are grouped in 4 categories with each one containing a subset of Tools, Practices and Processes that are used to implement in the field or clinic:

Assess

• We “assess" to evaluate your current state and measure dysfunction allowing us to determine what you need to optimize your health and fitness.

Screen

• We “screen" to determine your functional abilities and skill levels to best match the toolset you require to improve your assessment results and progress.

Test

• We "test" to evaluate potential areas of risk which dictates what you can and can’t or shouldn’t do and what weaknesses we need to work on to progress towards your goals and objectives.

Survey

• We "survey" to determine areas of your lifestyle and nutrition that may be contributing to under-performance, dysfunction or disease allowing us to implement incremental behavioral modifications to achieve your goals and support your training.

Tools, Practices and Processes

Core Screens, Assessments, Tests and Surveys

Screen: Vital Signs

The easiest and most beneficial screening test a Practitioner can perform is basic resting heart rate, blood pressure and temperature. These are all easily accomplished with low cost quality tools purchased online. In addition with the advent of Covid and increased knowledge and awareness of virus and respiratory diseases, both blood oxygen saturation and respiratory rhythms can be easily evaluated. Note that the platform’s artificial intelligence will interpret the results based on the most recent medical research but any variation outside the norms or healthy ranges should be immediately referred out to a qualified licensed health partitioner.

Assessment: Regional Adipose Tissue Deposit Profile (RATDP)

The RATDP?? is a core proprietary assessment performed by a Six Sigma Fitness Certified Practitioner that determines the Client/Athlete's overall body composition. A key Assessment Methodology in the DMAIC “Measure” phase, the test includes 12 specific measurement sites to determine where and how the body is depositing fat in different regions. It can be performed with a handheld ultrasound or a research grade set of calipers (Tools).

It is the depositing of fat at higher or excessive rates in specific areas of the body that has been shown to have a strong correlation with various chemical and hormonal imbalances inside the human body (Hormonal Influence on Body Fat Distribution). Once these are measured, the system's algorithms and artificial intelligence correlates and maps the findings to the publicly available body of research related to the findings. The system will automatically create a comprehensive health and fitness report making recommendations on lifestyle, nutrition, supplementation and movement that would best address the issues.

In addition to the body composition data, the system provides a comprehensive macronutrient profile tailored to the individual's metrics. This macronutrient profile can then be used to generate meal planning and dietary plans to support the Client/Athlete's objectives. In addition the system creates an optimal forecasted time period in which the client can achieve their weight goals based on quantified research surrounding the physical limitations on fat, muscle and water tissue loss.

A Weight Class Athlete module is also available to generate a complete weight gain/loss profile from time of assessment to the athlete's event date. The system will calculate the optimal and exact fat, muscle and water loss required to make weight safely and for performance optimization. This tool can be used to determine optimal weight class performance but cannot guarantee at which weight class the athlete will be most competitive as that also requires an analysis of their performance vs the competitive forces they face such as other athletes. The profile can be used to determine if a weight gain or loss is achievable within the desired time frame so that Coach's and Athletes may make safer and more precise decisions that may affect competition.

Test: Metabolic Testing

Caloric burn rate or energy expended is a core Test in the DMAIC “Measure” phase. The Six Sigma Fitness app will calculate the Client/Athlete's RMR based on normative population equations. This equation has been known to have a standard of error of 14% in some studies. It is recommended that a metabolic cart (Tools) test is performed to determine exact RMR using Indirect Calorimetry, especially in high level athletes with higher levels of muscle tissue than the normal population. In the absence of a medical grade metabolic cart, the system will generate the resting metabolic rate using evidence based population predictive formulas. At Six Sigma Fitness?? we perform a metabolic RMR test to determine exact energy expenditures and utilize the systems predictive algorithms to determine total energy expenditures for daily movement and exercise programs. This test further drives precise macronutrient profiles to achieve the Client/Athlete's goals with less trial and error.

The Nutrition and Macronutrient module will calculate the Client’s RMR using an accepted evidenced based formula if you don’t have the testing facility or equipment for an indirect calorimetry test.

Survey: Goals and Objectives, PARQ, Nutritional Log

The initial process of working with a Client should always include a relevant survey of what they are wanting to accomplish and their why for doing it. (Define in DMAIC) Our Onboarding surveys that can be taken online before the initial visit can accomplish this task easily. Waivers and or risk assessments such as the PARQ can be created, assigned to a Client and then signed online with any mobile or touchscreen device. Lastly, Nutritional logs (Measure in DMAIC) are difficult and tedious for Clients to track thus introducing process friction and reducing efficiency, a violation of Lean Six Sigma. Nothing tells a story like a picture. The Nutritional Log module will allow you to Survey your Clients nutritional habits at each meal or feeding with a quick photo from their phone uploaded to the app along with any pertinent data and notes for your review.

Other Screens, Assessments, Tests and Surveys

The Six Sigma Fitness?? system also provides for other scientifically accepted Methods within the Framework including movement Screens such as the FMS, VO2 max Tests, nutrition and recovery Surveys... and is adding new Methodologies, Tools and Processes as science evolves and as requested by the Health Practitioners.

Programming Methodologies

Programming falls under the Improve phase on DMAIC. Within the Framework of Six Sigma Fitness and DMAIC there exists many Programming Methodologies. Within those Methodologies is a suite of Tools, Practices and Processes that are utilized to apply the methods.

Our proprietary artificially intelligent Cloud-based technology utilizes our RATDP?? to chart a plan of attack within the Improve phase of DMAIC using one of 5 program Methodologies: Lean, Agile, Scrum, XP (Xtreme Programming) and HESEA??. Each one has a specific assigned length and style of movement programming, nutrition, supplementation and lifestyle habits that have been designed specifically to address your assessment results as well as your personal goals and constraints. This is a new and revolutionary approach to your health and fitness. Click on the link for more details on each below:

• Lean
• Agile
• Scrum
• XP
• HESEA??

Lean (MRT, LAT, DBT and HESEA??)

A typical Lean Methodology program follows a learn – measure – build cycle, and conducts many evaluations during the program. Lean is defined by communicating with clients frequently , understanding the objectives, and focusing its key processes to continuously improve. Lean focuses on the flow of the process of getting healthy and fit. Although weight-loss may be a goal, feeling better and regaining better health may be of significant value to the Client. Additionally, the Client may need to revisit the process over and over again during the Control phase of DMAIC. As such the flow and process must be optimized. A continuous cycle leads the client to sustainable weight management, health and fitness, smart training development, and success.

Lean is about squeezing out efficiencies in the process to achieving health and wellness. Lean is incremental and iterative. It is a methodology focused on streamlining and cutting out wasted effort and focusing on the least few that comprises the biggest potential return on time and resources invested. The first step is to create new habits and behavioral patterns that identify and eliminate bottlenecks, obstacles, and wasted efforts to get to your goals. The goal is to do more with less — to deliver value to the client through results that use less time, less energy, and less required effort. Lean focuses on inefficiency and wasted time and efforts from "unnecessary” steps in the health and wellness process that do not have a significant effect to the end result. While Six Sigma asserts that inefficiency and wasted time and efforts results from variations within the process such as inconsistent exercise, too many non-compliant meals, excess alcohol or lack of sleep, Lean makes the process of reducing variation more efficient by focusing on the the vital few at the expense of the trivial many.

The value to the Client is enhanced by getting to the end result efficiently and expediently with the least amount of friction. The target objectives are fixed and obtainable.

There are 4 primary movement programming paths within the initial Lean methodology:

1. Metabolic Resistance Training - Weight loss and Health
2. Lactic Acid Training - Weight loss and Health
3. Density Based training - Weight loss and Health
4. HESEA?? - Maintenance and General Health Balance

Once a Client achieves a healthy weight and performance level set by the Practitioner and Client together, they may then choose to move into more Specific Performance Programming such as strength training, long distance endurance, bodybuilding... or they may stay in a healthy maintenance mode.

Lean is about eliminating waste and inefficiencies. The identification and removal of impediments to exercise, healthy eating, good lifestyle habits... is paramount to long range success in the Lean program. More importantly they create a roadmap or playbook for the future as the Client will learn to become alerted to variations in their health KPI’s early enough to intervene and begin identifying the source of the problem and quickly eliminate the impediments to getting back on track.

Waste and inefficiencies that impede program advancement:

• Over-training - Poor ROI on time and effort invested, diminishing returns
• Waiting - on workout explanation, exercise instruction, Rest and Transitions
• Lack of Equipment or not enough equipment
• Travel to and from training or consultations
• Poor and inefficient Technique
• Over complicating Programs
• Underutilized Skills

Agile

The Agile Methodology of Improvement Programming was created for an athlete preparing for a specific event. It is best used for unique goals that may not always be repeatable due to unique circumstances. Using the same Lean evaluations and improvement methodologies, Agile is applied to athletes that need to be prepared for a specific event in a specific time period. It’s best suited for programs and sport camps that face diverse changes during their progress but may have an 8-12 week or even a 6 month window to reach the event. Its strength lies in its ability to frequently and rapidly deliver small parts of the goal in continuous sequence. It is most important to achieve the end goal focusing on quality when the end result is important as in preparation for an athletic event. It delivers frequent and quick feedback for the Athlete to learn and improve rapidly. The value of the process to the Athlete is a moving target that gets redefined with ongoing feedback.

It’s primary principals are:

1. Consistent delivery of results to keep the Athlete motivated and on track giving them a sense of satisfaction of control and success of achieving milestones of the plan.
2. Making changes to exploit the Athlete’s specific competitive advantages
3. Frequent delivery of results utilizing KPI’s to set checkpoints in the process.
4. Close daily collaboration among Coaches and Athlete.
5. A culture of strong trust between the clinician and their team and the Athlete.
6. Constant communication in person when possible, or visually online.
7. Measuring progress continuously with a focus on consistently improving on the end goal.
8. The pace and progress of the Team needs to be sustainable due to the shorter timeframes and specific event goal that must be met.
9. Due to the short time period, technique and quality of service delivery is paramount to the process. There is no room for mistakes or back-tracking.
10. A focus on the least amount of work for the highest amount of return or optimization is important to reduce risk of injury or overtraining. Simplicity is favored over complexity at this stage.
11. Allow the Coaching team to meet and organize the process to optimize for the end result as they deem fit. Rigid guidelines don’t allow for frequent and rapid changes required to optimize the process.
12. The Coaching Team and athlete must rapidly evaluate the training process and programs to determine how to become more effective moving forward allowing the Athlete to optimize gains.

Scrum

The Scrum Methodology is a subset of Agile. It is best defined as doing twice the work in half the time. Scrum is a simple yet incredibly powerful set of principles and practices that help Coaches and Practitioners deliver services in short cycles, enabling fast feedback, continual improvement, and rapid adaptation to change. The fundamental principle of Scrum is that by splitting time, programming, and resources into continuous parts, you optimize the process and guarantee impressive results.

Here’s how it works: an individual establishes small discrete goals such as a daily habit, breaks down the process to achieve them into action steps and incrementally changes their behaviors each day until the goal is met. A continuous process of performing small tasks for short periods of time (e.g. one to two-week Sprints) allows you to reach a larger goal in a shorter time period. The client may track their progress on Scrum or Kanban (Trello) style boards of tasks and habits which have the following sections: habit and behavior backlog, changes to be made (on deck), habit and behavioral changes in progress, and permanent habit and behavioral changes completed. Compliance tracking is paramount to the process.

In Scrum, performance cycles are called Sprints. A sprint is a short (typically two-week) period in which the Practitioner and Coaching team focuses on building a tightly scoped set of goals, habit changes and programming. They choose and modify what those programs and methods will be on a rolling basis. A typical sprint looks something like this:

Phase 1 - Sprint planning. The team, which includes Practitioners as well as other key stakeholders like coaches, personal trainers or Nutritionists determines what new modifications are highest priority for the next sprint to deliver. Phase 2 - Sprint. Each team member works on their portion of the client program, checking in regularly—often times daily—to update on the changing progress and request help as needed. Phase 3 - Retrospective. At the end of the sprint, team members present their progress and reflect on the client results in the sprint. New needs are surfaced, and changes are made to program and strategy.

XP

The Xtreme Programming or XP Methodology is a form of Scrum with a condensed timeline that consists of a high intensity focused effort to accomplish its goals and objectives. It is normally a primary focus on one particular goal such as reduced weight to meet a compliance requirement such as a wrestling or weightlifting meet, reduced waist size to fit into a dress for an upcoming wedding or dinner, increased deadlift to get past a plateau, faster 40 meter for team trial such as the combine... or rapidly accomplish a particular habit like getting adequate and quality sleep for recovery. It is an overload of stress and adaptation or health recovery for a very confined period of time to break through plateaus and limitations the athlete may be experiencing. The process gives less consideration to the methods and long-term effects making sacrifices to achieve the short-term goal.

XP programs are normally best served in person due to the nature of the intensity of the work involved. They also prioritize results over long-term health or future objectives. They need not be in conflict with longer-term goals and objectives but most likely may sacrifice short-term aspects of health or wellness in lieu of short-term results.

HESEA??

The HESEA?? Programming Methodology is a maintenance system to balance movement programming once a targeted level of weight, body composition and health and wellness factors have been reached. It can be used to maintain a Client’s goals and objectives long-term. The acronym represents 5 programming units as follows:

1. Hypertrophy
2. Endurance
3. Strength
4. Endurance
5. Active Recovery

Example DMAIC Framework Applied in Practice

A typical DMAIC process is similar to a typical Medical SOAP methodology explained below and would look like this:

Define:

Define the issues: Client is visibly overweight, feels fatigued and may have metabolic syndrome. Determine the Methodologies, Tools, Practices and Processes to be used to Measure the baseline data that will determine a successful outcome.

Measure:

• Perform a body composition (Assessment) with a handheld ultrasound or research grade calipers (Tool) - RATDP?? module.
• Calculate or measure RMR (Test) utilizing a medical grade metabolic cart or performing a scientifically valid predictive formula (Tool)- RATDP Nutritional/Macronutrient Profile submodule
• Take blood pressure (Screen) and or other Vital Signs utilizing a blood pressure cuff (Tool) - Vital Signs module
• Refer to Physician for blood glucose test (Test), self test or perform a glucometer (Tool) test. - Biomarkers module
• Evaluate nutritional habits for 3 days (Survey) utilizing the Nutritional Log module (Tool),

Analyze:

Review the calculations, protocols and RATDP?? summary in the Six Sigma Fitness?? app after entering the results of all Screens, Assessments, Tests and Surveys. Review Health and Fitness Report for Client. Modify or edit data input as necessary. Have client login to their Dashboard and review the Health and Fitness Report. Begin to define goals, objectives and targets to aspire to.

Improve:

Begin a Lean Program of MRT, LAT or DBT based on the Health Report protocols until client reaches a weight and or health goal and reassess and adjust every 2 weeks or as Practitioner deems necessary. Analyze the results of the calorie and macronutrient assessment and set appropriate caloric deficits and macro ratios as targets. If blood pressure screen results is abnormal per the health report Vital Signs Screens performed by the Practitioner and interpreted by the app, refer out to physician for further evaluation. If glucometer test results are out of range as interpreted by the Biomarker health report refer out to a physician. Adjust supplementation, recovery and mental and physical health habits to achieve the goals within your scope of practice in your geographic local.

Control:

Monitor the results and repeat Screens, Assessments, Tests and Surveys on a predetermined schedule and adjust the Improve protocols as required to make progress towards the Client goals.

What is the SOAP method in medical terms?

In modern clinical practice, doctors share medical information primarily via oral presentations and written progress notes, which include histories, physicals and SOAP notes. SOAP—or?subjective, objective, assessment and plan—notes allow clinicians to document continuing patient encounters in a structured way.