Are Exercise Physiologists Key Professionals for Healthcare Evolution?
Marcos A. Sanchez-Gonzalez, M.D., EPC
Ph.D. Student Exercise Physiology
Cardiovascular Physiology Laboratory
100B Sandels Building
Department of Nutrition, Food and Exercise Sciences
College of Human Sciences
Florida State University
Tallahassee, FL 32306
marcossanchezmdepc@gmail.com

In the biological world, the capacity of each population to evolve is one of the essential elements responsible for the survival of the species. The ability to adapt effectively to the constant imposed changes from the surrounding environment is truthfully the difference between continued existence or an inevitable extinction. A very similar comparison is applicable to the society, emerging and well-established institutions, and various types of industries.  Most importantly, evolution is necessary for the enhancement of individuals or groups that offer very specific professional services. The Exercise Physiologist is not an exception to this rule since his/her proficiency in several specific areas of healthcare-related services is necessary for the diagnosis, treatment and well-being of patients.

Despite the well-known health-related benefits of physical exercise, most medical professionals do not recommend exercise as therapy to their patients [1-5]. For example, a series of questionnaires among United Kingdom physicians revealed that they did not recommend exercise in 55.9% of cancer patients. However, physical activity was recommended only for apparently healthy individuals. This practice may neglect the benefits of physical exercise on these cancer patients [2]. Many healthcare professionals do not feel comfortable counseling their patients on physical activity issues, principally due to their lack of knowledge regarding general exercise guidelines and prescription [6].These current examples represent some of the multiple challenges that the profession of Exercise Physiology encounters daily and call to our attention two interesting questions. Does Exercise Physiology deserve a place among key healthcare disciplines and specialties? Can Exercise Physiologists avoid the healthcare deterioration?

A recent line of exercise based programs point out the fact that Exercise Physiologists should be in a key position for improving healthcare services. Well-structured exercise training programs and a multidisciplinary collaboration between diverse groups of professionals characterize many of these programs. One interesting program was the Erlangen Fitness Osteoporosis Prevention Study (EFOPS) conducted by Kemmler and coworkers. The aim of this program was to prevent osteoporosis in postmenopausal women using strength and aerobic conditioning programs. The contributions made by Exercise Physiologists were critical since no medications were used during the study. Analysis of data after the study was completed showed that not only bone mineral density improved but also other health related variables as strength, aerobic capacity and a reduction in body fat [3]. Exercise Physiologists played an extremely important role during EFOPS since their primary responsibility was the development of the exercise treatment.

Many patients affected by chronic diseases are experiencing the favorable changes that exercise programs, guided through exercise physiologists, can offer. Multiple Sclerosis patients are improving quality of life and limiting the progression of their disease [4]. Many obese patients are more confident about themselves because they feel more energized and happy [7]. Chronic Fatigue Syndrome patients are having significant improvements on their health status [5].  These results, in addition to many other favorable outcomes, are without any doubt a tangible confirmation of the positive impact that Exercise Physiologists have on healthcare.

The typical medical treatment model recommends a combination of different approaches in order to manage and control the progression of chronic diseases. Therapeutics relies on pharmacotherapy, diet, surgery and exercise. These modalities are not new or unknown by the general population. The majority of cardiac and diabetic patients know that they must follow the prescriptions and recommendations that their healthcare providers give in order to maintain their disease under control. In most of the cases following a structured schedule for pills, medical appointments and foods do not include a well-balanced exercise program. In fact, an astonishing 56% of patients with disabilities do not engage in any regular physical activity [1]. This represents an important public health problem since many of this patients are challenged by the risk and complications that a lack of physical exercise may cause [1, 8].

Although the favorable health effects of physical fitness oriented programs are unquestionable, patients are often excluded from participation in exercise training. Some fear exists since many of them believe that there are no capable or qualified personnel who can deal with their particular disease [6]. The Exercise Physiologist should fill the void of a critical healthcare deficiency that is causing an accelerated deterioration of the nation’s health status. Everyday, many physicians prescribe internal consultations or referrals in order to provide a better quality of life to his/her patients. However, an obvious and essential referral is not being prescribed as frequently as it should.

There is one important referral missing in this formula that will promote the evolution of healthcare. Thus, what can be wrong about a consultation with an Exercise Physiologist? As a credible professional, the exercise physiologist with knowledge on exercise and chronic disease management is capable of providing the necessary planning for a successful exercise program. The profession of Exercise Physiology is constantly being excluded from the medical therapeutic model each time that a patient is excluded from exercise training. Healthcare is being restricted to three out of four treatment modalities and the need for improvements in this way of thinking disserves the attention of every Exercise Physiologist interested in the possibilities that this profession can offer.

The major components of health are in the hands of competent and committed Exercise Physiologists. In this particular time of history when chronic disease patients and healthcare are deteriorating, Exercise Physiologists are necessary, valuable and indispensable for the restructuring of the country’s general health. A healthy country is a productive one; an unhealthy country is not able to progress. Healthcare is in a desperate need of change and Exercise Physiology and ASEP initiative is the necessary key for starting this process. This change must start today making Exercise Physiologists responsible for the challenges that it may represent.

References

1. Boslaugh, S.E. and E.M. Andresen, Correlates of physical activity for adults with disability. Prev Chronic Dis, 2006. 3(3): p. A78.

2. Daley, A.J., et al., What advice are oncologists and surgeons in the United Kingdom giving to breast cancer patients about physical activity? Int J Behav Nutr Phys Act, 2008. 5(1): p. 46.

3. Kemmler, W., et al., Benefits of 2 years of intense exercise on bone density, physical fitness, and blood lipids in early postmenopausal osteopenic women: results of the Erlangen Fitness Osteoporosis Prevention Study (EFOPS). Arch Intern Med, 2004. 164(10): p. 1084-91.

4. White, L.J. and R.H. Dressendorfer, Exercise and multiple sclerosis. Sports Med, 2004. 34(15): p. 1077-100.

5. Whiteside, A., S. Hansen, and A. Chaudhuri, Exercise lowers pain threshold in chronic fatigue syndrome. Pain, 2004. 109(3): p. 497-9.

6. Arida, R.M., et al., Physical activity and epilepsy: proven and predicted benefits. Sports Med, 2008. 38(7): p. 607-15.

7. Daley, A.J., et al., ;I Can Actually Exercise If I Want To; It Isn't As Hard As I Thought': A Qualitative Study of the Experiences and Views of Obese Adolescents Participating in an Exercise Therapy Intervention. J Health Psychol, 2008. 13(6): p. 810-9.

8. Perri, M.G., et al., Adherence to exercise prescriptions: effects of prescribing moderate versus higher levels of intensity and frequency. Health Psychol, 2002. 21(5): p. 452-8.