Clinical Exercise Physiologist. Is this a professional with a unique knowledge base and skill set that is qualified to work with a variety of individuals with chronic diseases or those at risk? Yes. Is this an allied health profession? Yes. Is the term Clinical Exercise Physiologist often misconstrued with the similar term Exercise Physiologist? Yes. Is this an important distinction? Unfortunately, the answer again is, yes. Why does this matter? To answer this, I must go back to 2014 when I was on the Board of Trustees of the American College of
Background: Clinical placements are invaluable for preparing students for their professional role and assisting the transition to practice. In order to thrive, it is the responsibility of universities to ensure students are prepared. The aim of this study was to examine the student response to learning within a university clinic-as-classroom educational program, for building self-perceived confidence to perform the competencies of clinical exercise physiology practice, prior to their first clinical placement. A secondary aim was to identify any learning areas that required further emphasis within the curriculum.
Methods: This study was a prospective cohort study, assessing the change in confidence of 80 final year exercise physiology students to perform the competency of practice.
Results: The study achieved an 87% response rate. Baseline data indicated students were confident to behave professionally, be reflective, work in teams, adapt to practice setting, ensure a safe exercise environment, and manage personal risk. Across the clinic-as-classroom program students reported a significant growth in confidence in 4 elements of competency: communication of data; placing the clinical exercise physiologist's role in the wider healthcare context; designing client centered exercise interventions; and integrating pathology into the program planning and delivery.
Conclusion: The clinic-as-classroom educational program allowed novice students to become increasingly confident in the clinical environment in a low-risk, authentic, and supportive learning environment. A key recommendation was to embed the additional elements of clinical exercise physiology practice across the course and clinic-as-classroom curriculum to increase student preparedness for placement.ABSTRACT
The current state of the profession of clinical exercise physiology in the United States is that of evolution. Individuals now identified as clinical exercise physiologists (CEPs) first emerged in health care in the nascent cardiac rehabilitation programs in the late 1960s and have remained strongly identified in that role ever since. However, the profession has had difficulty expanding into other similar areas, largely due to the lack of standardized academic preparation. This contributes to uncertainty and confusion among other health care providers regarding appropriate roles and responsibilities for a CEP. Future directions for the profession of clinical exercise physiology include requiring certification candidates to graduate from accredited programs so the academic preparation becomes standardized. The American College of Sports Medicine (ACSM) is currently investigating modifying the eligibility criteria for the ACSM-CEP certification to address this requirement. The Clinical Exercise Physiology Association is currently assembling a writing team to draft a CEP scope of practice document for the support and endorsement of other professional organizations The last item is the strengthening or creation of liaisons with other professions to develop a collaborative care model that takes full advantage of the skillset CEPs bring to chronic disease management.ABSTRACT
While the field of exercise oncology has substantially progressed in recent years, a significant void exists in the inclusion of and focus on minority patients diagnosed with cancer, particularly blacks and Hispanics. Blacks and Hispanics are less physically active, experience higher rates of comorbid conditions, and have poorer cancer prognosis when compared to white counterparts. Exercise prevents and reduces an array of health conditions, including cardiovascular disease, diabetes, obesity, and risk of certain cancers. However, black and Hispanic cancer survivors are underrepresented across exercise intervention trials. In this review, we discuss previous explorations among minority cancer survivors with a focus on exercise prescription, targeted outcomes, patient demographics, and barriers to exercise. We also discuss knowledge gaps and future directions necessary to progress the field of exercise oncology to include a more diverse cancer survivor cohort. In brief, we found few studies have evaluated the effect of exercise on physiologic health outcomes in black and Hispanic cancer survivors, with much research focused on psychosocial health. A majority of minority population-based research specifically targets the black breast cancer survivor population, with reported exercise-induced improvements observed in weekly physical activity, cardiorespira-tory fitness, muscle strength, quality of life, and fatigue. Minority cancer survivors also face unique challenges and barriers to exercise participation despite acknowledgement of the benefits with physical activity. Future investigations warrant explorations of exercise timing across the cancer continuum, inclusion of different types of cancer survivors, and novel exercise strategies with inclusion of culturally tailored educational and behavioral components.ABSTRACT
Background: This study reports on breast cancer survivors' compliance to the exercise prescription (ExRx) of a personal training (PT) or group-based (GB) exercise intervention.
Methods: Breast cancer survivors who had completed chemotherapy and/or radiation within the previous year were randomly assigned to PT or GB. All participants completed supervised aerobic and resistance training sessions twice per week for 8 weeks. Compliance to aerobic and resistance exercise intensity (i.e., % heart rate reserve, and % 1-repetition maximum [1-RM]) and aerobic exercise duration ExRx is reported, and average aerobic and resistance exercise intensity was calculated. Independent t tests compared percent compliance and average intensity between PT and GB. The proportion of participants above or below ExRx was examined using frequencies.
Results: ExRx compliance ranged from 64% to 98%. Compliance to aerobic exercise intensity and duration was higher in PT than GB (P < 0.05). Average upper body resistance training exercise intensity was higher in PT (73% 1-RM) vs GB (56% 1-RM) (P = 0.01). Noncompliance to aerobic ExRx was more commonly due to intensity or duration below the ExRx. Noncompliance to resistance training ExRx was distributed equally above or below ExRx.
Conclusion: Compliance to aerobic ExRx and average upper body resistance training intensity was higher in PT, suggesting that exercise professionals in GB settings should consider closely monitoring breast cancer survivors' adherence to ExRx.ABSTRACT
Verbrugghe J, Agten A, Stevens S, Hansen D, Demoulin C, Eijnde BO, Vandenabeele F, Timmermans A. Exercise intensity matters in chronic nonspecific low back pain rehabilitation. MSSE. 2020; 51(12):2434–42. Globally, chronic lower back pain (LBP) is the leading musculoskeletal disorder in men and women of all ages (1), and people with a lower back disability have it longer, on average, than any other disability (2). LBP is the most common cause for workplace absenteeism and burdens many health care systems (2). Only a small percentage of chronic LBP cases are caused by a specific