CLINICAL EXERCISE PHYSIOLOGY - AN OVERVIEW

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Clinical Exercise Physiology focuses on the epidemiology and pathology of chronic diseases, it deals with the understanding of the physiological and psychological factors associated with disease, and the role of exercise as a medicine in the prevention, treatment and management of these conditions.
A Clinical Exercise Physiologist monitoring the progress of a patient.
Clinical exercise physiology focuses on using 'exercise as medicine', to treat and manage conditions as well as to rehabilitate patients recovering from illness.  They help patients with heart disease and other chronic conditions, like diabetes or pulmonary (lung) disease, to regain their health. 
With ever-increasing numbers of patients being referred for exercise-screening and prescription - especially those diagnosed with chronic conditions such as coronary heart disease, type 2 diabetes and metabolic syndrome - correct determination of exercise tolerance and prescription is an essential component of their wellbeing and return to normal lifestyles. There is currently a significant shortfall in the number of qualified cardiac physiologists, with patients in some areas on long waiting lists, meaning these skills are in high demand around the world (Salford, 2018)
The Body of Knowledge for a Clinical Exercise Physiologist includes;
Advance Exercise Physiology - Developing skills in reporting and evaluating research on human physiological responses to exercise and training and to advance practical skills in major areas of measurement and programming.
Pathophysiology and aetiology of health disorders – Exploring the factors relating to disease and how exercise may be used to manage the disease states.
Encouraging the self- management of healthy lifestyle behaviours – EvaluatING the health benefits and reduced risk of disease by following government recommendations for exercise and a healthy diet, paying attention to evaluating the potential effect of environmental and psycho-social influences on lifestyle choice. Educating patients to self-manage lifestyle change in treatment of disease.
Clinical exercise testing and prescription for health disorders – Understanding the clinical presentation of disease states and the application and interpretation of exercise testing.
Morbid Anatomy and Physiology: Studying the study of disordered structures and functions in a diseased tissue or organ.
Career Opportunities for a Clinical Exercise Physiologist
A clinical exercise physiologist work may also be done in the following places;
1)       Public and private hospitals settings
2)       Primary, secondary and tertiary health care
3)       Within private and multidisciplinary clinics
4)       Population health
5)       Workplace health and rehabilitation
6)       Ageing and aged care

DUTIES OF A CLINICAL EXERCISE PHYSIOLOGIST
According to the University of Alabama (2018), the following are duties of a clinical exercise physiologist;
1.      Provides multidisciplinary rehabilitative care to the cardiac and pulmonary clinical patient population.
2.      Assesses patient s exercise, educational and behavioral needs.
3.      Work as a team member with the registered nurse, establishes rehabilitation goals and implements individualized care plans.
4.      Assumes leadership role with multidisciplinary team as an exercise specialist guiding exercise prescription, exercise profession and exercise modalities for patient population.
5.      Core competencies include demonstrated understanding, knowledge and skills related to care of cardiac and pulmonary patients.
6.      Responds to the unique needs of all patients ages newborn through geriatric.
7.      Also interacts with patients during clinically oriented research and adapt exercise protocols as appropriate based on patient needs and safety while remaining consistent with the research protocols.
8.      Performs exercise testing according to protocol.
9.      Lead exercise specialist for funded, pilot, and start-up research projects.
This involves the following:
a)      act as the go to person for the exercise specialists working on cancer and exercise research protocols
b)      implement intervention and assessment protocols for cancer and exercise research studies
c)      develop and update research intervention and assessment protocols related to exercise and body composition
d)      train and monitor for quality control other exercise specialist staff implementing research intervention and assessment activities for research studies
e)      maintain Basic Life Support (BLS) instructor status and certify all exercise and cancer project staff in BLS (and first aid) on an annual basis
f)       perform administrative duties related to exercise specialists working on research projects (e.g., tracking hours worked, completion of administrative forms, etc.).

Limitations to Practice for a Clinical Exercise Physiologist
An exercise physiologist is not a personal trainer or a physiotherapist. However, it is common to see some individuals having a background in these fields.
Physiotherapists are specialists at diagnosis, treating and managing acute injuries or acute flare-ups using manual therapy along with acute exercise prescription while an accredited clinical exercise physiologist is also an allied health professional who specialises in chronic disease or injury management by prescribing exercise to assist/improve that patient’s management of their chronic disease.
Clinical Exercise Physiology Present Situation in Nigeria
As a clinical exercise physiologist, an individual generally need to:
  • perform a range of investigations, including exercise tolerance tests, to assess patient risk
  • work directly with patients on how to make changes to their lifestyle
  • refer patients where necessary to other specialists
  • work as part of a multidisciplinary team including clinicians and allied health professionals
  • teach and present to allied related medical staff
  • work with community groups, volunteers and local councils to raise awareness of the benefits of exercise.
In Nigeria today however, there is very low demand for employment of a clinical exercise physiologist across many clinics. Although there are lots of individuals who needs the services of a clinical exercise physiologist, however the low demand might be as a result of the course not being available in many Nigeria Universities, and this has resulted in a very low amount of qualified clinical exercise physiologist available in the country. Most of the times, a physiotherapist continue the chronic disease or injury management by prescribing exercise to assist/improve that patient’s management of their chronic disease which should be the work of a clinical exercise physiologist.
Certification
You'll usually need a degree in sports science or a closely-related subject. Relevant undergraduate sport and exercise science degrees are based around physiology, kinesiology, exercise science, physical education, biomechanics and psychology, and you'll be expected to have a broad knowledge base covering all three subjects and interdisciplinary approaches. A postgraduate degree in Exercise Physiology or Clinical Exercise Physiology is usually preferred.
The need for Clinical Exercise Physiologist in Nigeria
The increase in the incidence of individuals with various non-communicable diseases in the country makes the service of a clinical exercise physiologist needed in the country. They can help patients with recovery from heart disease and other chronic conditions, like diabetes or pulmonary (lung) disease, to regain their health to the norm. 
Suggestions Clinical Exercise Physiology Practice in Nigeria
1.      The need to create a degree specialized in clinical exercise physiology in Universities around Nigeria at the postgraduate level
2.      Creating policies in ensuring that clinics treating chronic disease or injury management by prescribing exercise should make sure they use qualified exercise physiologists.
3.      There should be more referrals to the clinical exercise specialist by hospitals to patients who need their services.
References
Salford (2018). Clinical Exercise Physiology. Retrieved on the 5th of September, 2018 from http://www.salford.ac.uk/pgt-courses/clinical-exercise-physiology)
University of Alabama (2018). Job description, Clinical Exercise Physiologisy. Retrieved on the 5th of September 2018 from https://uab.taleo.net/careersection/ext/jobdetail.ftl?job=T50107&tz=GMT-08%3A00


How to Reference this article

Ademola, V. D (2018). Clinical Exercise Physiologist. Retrieved from https://www.youdread.com/2018/09/clinical-exercise-physiology.html

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