What have health care professionals done to decrease rates of physical inactivity?

1 2 3 4 5 6 7 8 9 10 Careers in Clinical Exercise Physiology Credentialing, Scope, and Practice Jennifer S. Blevins, Ph.D. ACSM ES RCEP and Program Director SM blevinsj@uta.edu Exercise and Medicine Physicians Statement - applies exercise and physical activity for those clinical and pathophysiological situations where exercise has been shown to provide therapeutic or functional benefit i.e. patients for whom services are appropriate (American College of Sports Medicine, www.acsm.org) Cardiovascular, pulmonary, metabolic, immunological, inflammatory, orthopedic, and neuromuscular diseases and conditions Several certifications including a registry exam Past clinical exercise physiology Fernand LaGrange - book in late 1800s Harvard Fatigue Laboratory 1940s effects of fatigue and performance during war times 1950s and 1960s worksite epidemiological studies and development of exercise and health 1970 1990 cardiac rehabilitation programs Present clinical exercise physiology Surgeon General s report on physical activity and health 1996 Diseases related to a lack of exercise Cancer, cardiovascular disease, falling, health related quality of life, non-insulindependent diabetes, mental health, obesity, osteoarthritis, osteoporosis, overall mortality Future clinical exercise physiology Academic background is and will be necessary for employment: Personal training, corporate fitness, medically affiliated fitness centers, sports consulting, weight management programs, cardiology testing laboratories Improved number of scientific journals New formation of Clinical Exercise Physiology Association The American Lifestyle: Does it actually contribute to chronic disease? Percent of U.S. citizens who do not participate in leisure time physical activity (LTPA) according to the CDC Slide 4 U.S. 25.8 % do not participate in LTPA Recommended amount 47% Texas??? No LTPA 39% Recommended amount 46% The American Lifestyle: Does it actually contribute to chronic disease? Smoking 21% of citizens currently smoke, really no change in prevalence rates from 1996 to present Diet Obesity Epidemic What have health care professionals done to decrease rates of physical inactivity? 1

11 12 13 14 15 16 17 18 Physical inactivity increases risks for certain chronic disease and continues to be a major health concern in the US population Inadequate functional capacity among individuals with major chronic diseases Low functional capacity reduces quality of life Low functional capacity imposes social and financial stresses on families and communities National Health Interview Survey (NHIS) Comorbid conditions 46.4 million (21.6%) of adults have self-reported doctor-diagnosed arthritis. 18.9 million (8.8% of all adults) have arthritis-attributable activity limitation. Low back pain is usually more prevalent than high blood pressure or high cholesterol in most workplace surveys. What s the likelihood that I will actually have to supervise or treat someone during exercise with risk factors for chronic disease? Smoking High cholesterol Sedentary High levels of glucose in the blood or diabetes Overweight or obese Family member with heart disease at an early age High blood pressure Others American Society of Exercise Physiologists (ASEP) one certification that requires academic competency and skill acquisition ACE no scope of practice no degree required Career Paths for the CEP Health and Fitness Fitness Programs Personal Training (healthy and clinical) Wellness Programs Corporate Fitness Health Rehabilitation Exercise Physiology Nursing Occupational Therapy Physical Therapy Dietetics Establish a sound academic base Obtain credentials through the American College of Sports Medicine (ACSM) certification and registry process ACSM SM Health Fitness Instructor ACSM Exercise Specialist ACSM Registered Clinical Exercise Physiologist (RCEP) AHA Basic Life Support and Advanced Cardiac Life Support 2

19 20 21 22 23 24 25 26 Obtain experience experience experience! Academic preparation of the CEP Graduate Schools in Clinical Exercise Physiology Masters (http://www.wfu.edu/hes/)1.5 2 years 30 to 40 additional hours of course work Prerequisites Thesis and Non-thesis Ph. D. 3.5 ---? Years 40 to 60 additional hours of course work Prerequisites Qualifying, Preliminary exams, Dissertation Licensure and Registration in the Exercise Sciences Licensure government agency grants an organization or individual to engage in a practice that would otherwise be illegal I.e physicians, nurses, PT, etc. Registration recording of professional qualification information relevant to government licensing regulations Narrower scope of practice than licensure What kind of job can I get as a CEP? Why should I obtain credentials? Sets you apart with distinction Provides you and your place of employment with professional credibility Provides you with a competitive edge Enables you to take on more work-site responsibilities Expands your opportunities for acquiring employment & advancement in the field American College of Sports Medicine is the exercise physiologist credentialing body. Why Credential with ACSM? ACSM credentials are the gold standard & are well-respected in the field ACSM certification is endorsed by other professional organizations Certification requires higher pre-requisites Demonstrates experience, knowledge, skill and ability Certified providers deliver a standard of care ACSM Health Fitness Instructor An Associate s Degree or Bachelor s Degree in a health-related field from a regionally accredited college or university One is eligible to sit for the exam if the candidate is in the last term of their degree program Possess current CPR certification ACSM Health Fitness Instructor Written Exam (3 4 hours) Practical Exam (3 stations 2 hours) Body composition Aerobic fitness testing Muscular fitness and flexibility; group exercise 3

27 28 29 30 31 32 ACSM Exercise Specialist A Bachelor s degree in an allied health field from a regionally accredited college or university 600 hours of practical experience in a clinical exercise program including fitness testing (eg. cardiac/pulmonary) Possess current CPR certification ACSM Exercise Specialist Written Exam (3 4 hours) Pathophysiology Pharmacology Exercise testing and prescription Metabolic Calculations Electrocardiography Practical Exam (6 stations 2 3 hours) ACSM Registered Clinical Exercise Physiologist A Graduate degree in exercise science, exercise physiology or physiology from a regionally accredited college or university 1200 hours of relevant clinical experience required in the following areas: Cardiovascular Metabolic Orthopedic/Musculoskeletal Neuromuscular Immunological/Hematological Pulmonary Experience in providing clinical exercise services for patients with chronic diseases and conditions RCEP EXAM Written exam of 4 hours 8 competency domains 200 items based on the KSA's Pathophysiology & Risk Factors 6 case studies with 30 add'l questions RCEP EXAM (con t) Questions cover / 6 practice areas Cardiovascular (25%) Pulmonary (15%) Metabolic (20%) Orthopedic/Musculoskeletal (20%) Neuromuscular (10%) Immunologic (10%) RCEP EXAM (con t) 8 Practice Domains Health/Medical Appraisal Exercise/Fitness Testing Exercise Prescription & Programming Education & Counseling 4

33 34 QA, Outcome Assessment, Discharge Planning Administration Scope of Practice Not just about cardiac or pulmonary rehabilitation The practice of the CEP should be restricted to clients who are referred by and are under the continued care of a licensed physician and Have no absolute medical contraindications to exercise Have a need to enhance their capacities for ADL s The CEP must have substantive interaction with the referring physician and may be required to solicit discharge summaries, referrals, progress reports, etc. The Professional s Choice ACSM certification provides the best credentials in health and exercise programming for clients and employers in preventive and rehabilitative programs An ACSM exercise professional has extensive education and training and has demonstrated a high level of knowledge, skill and ability as well as a commitment to the field 35 36 37 38 39 40 ACSM examinations are the most rigorous in the industry, requiring standards for educational knowledge and experiential skills and abilities Yeah but. Can I really get a job.a good, job if I choose CEP as my career choice? Examples from http://www.exercisejobs.com In the next 5 to 10 years, the staff involved in these new programs will be highly skilled clinical exercise physiologists, with responsibilities beyond cardiopulmonary rehabilitation. Exercise Science Certifications National Athletic Trainers Association Certified Athletic Trainer (ATC) CPR, BS from accredited college, internship Need to document CEUs every 3 years National Strength and Conditioning Association Certified Strength and Conditioning Specialist (CSCS) CPR and BS Need to document CEUs every 3 years 5