Focus on Exercise Physiology as a Regulated Profession
The profession of exercise physiology has grown tremendously in the last 10 years. Interest in developing some type of regulation is due to the expansion of the practice related to populations served and the expansion of medical applications in the profession today. The term "exercise physiologist" has come to be applied as a universal term to numerous fragments and tangent practices in the field. Due to the diversity of professional development and the overlap and/or inclusion in numerous other professions, it is felt a true definitive outline of the profession of exercise physiology is needed.
It is the overall purpose of this paper to delineate the definition of exercise physiology, to outline educational preparation guidelines, and ultimately regulatory control of the profession in relation to licensure.
The profession of exercise physiology has undergone a transformation from a research-oriented profession to a profession that provides practical application in the management of diseases and maintenance of healthy populations. Exercise is the major intervention component of the profession, but it is certainly not the only component emphasized in the training related to or applications utilized by the exercise physiologist. Due to the advancement of the profession into a diverse field of intervention spanning all aspects of health and wellness, it is indeed necessary to specify and differentiate the qualifications necessary to successfully practice in the present day clinical settings.
Present degree levels:
BS, MS, MEd, PhD, Degrees are awarded under a variety of field emphases such as kinesiology, exercise science, cardiac rehab, wellness, and exercise physiology. There is no uniform standard in programs.
Voluntary ---ACSM, IDEA, AFAA, NSCA, AHA
Vary from none to 3-6 months duration
Healthy and diseased
Varies; There are no set standards in the profession at this point.
Various; Due to the lack of standards in the field of exercise physiology, various professionals (physical therapists, registered nurses, athletic trainers) are practicing in the field as well as other individuals with little or no educational preparation or training.
It is herein stated and recognized that the profession of exercise physiology shall have uniform preparation to guarantee continuity of care and standards of care for all health and wellness populations. The professional progression and emphasis of care should include a wide spectrum of patient populations and guarantee the highest standards possible in educational background and practical application.
It is noted that although exercise is the primary intervention technique employed in the practice of exercise physiology, the field has developed to a point that an exercise physiologist must be prepared with a multi-disciplinary approach. Furthermore, there is a strong emphasis in patient education, as well as preventative strategies for the patient/client to fully realize the benefits of therapy by an exercise physiologist.
The following pages will further detail the educational emphasis and preparation for the profession of exercise physiology. It is to be noted that the position stand outlined by the Louisiana Association of Exercise Physiologists in this paper is closely aligned with the American College of Sports Medicine recommendations for professional preparation and ultimately regulation by licensure.
Outline: Components of Position Stand
A) Educational Emphasis as a Profession
C) Advantages of Professional Standards
A. Educational Emphasis as a Profession
2. Other program emphasis
3. Major disease emphasis
B. Philosophy of Practice
Patient/client education is a fundamental component of the intervention process in the management of health and wellness regardless of the initial level of health for each individual.
C. Advantages of Professional Standards
Professional standards are a benefit not only to the profession itself, but also to the patient/client, employer, and public health.
Professional standards allow for uniform application for the continuity of care of each individual. In the rehabilitation process the practices of exercise physiology have a positive influence of cost due to a more expedited recovery process. In the preventative process, the practices of exercise physiology have a positive influence on reducing the chances of a repeat event and/or the debilitation of a healthy individual.
2. Employer (Hospital or Private Clinic)
Professional standards solidify the overall practice of exercise physiology and prevent a risk of liability to the employer, patient/client, and practicing exercise physiologist. Ultimately, health care costs need containment in today's market in order to be competitive, and standards of care within the profession would help to contain these medical costs.
3. Public Health Costs
Professional standards for exercise physiology would guarantee the public the educational background and preparation of everyone entitled as an exercise physiologist. The regulation of the profession would provide the public with standards of care and expected methods of treatment.
Professional standards would also provide a safeguard to the public that all those individuals entitled as an exercise physiologist have undergone a standard process for obtaining training in exercise physiology.
The public would be assured that all therapy and treatment is the most recent and up-to-date in the industry and provides for the reduction of safety risks and injuries related to the practices of exercise physiology.
4. Professional Costs
Professional standards provide self-regulation by individuals who are actually practicing in the field of exercise physiology.
Professional standards would reduce the overall liability to each individual practitioner due to uniform educational background and preparation.
Professional standards would help the exercise physiologist to maintain an optimum program of treatment for cost containment of health care.
D. Licensure of the Profession
It is herein stated that there is a definite need to bring regulations to the profession of exercise physiology. It is the position of this paper to note that although licensure may be the ultimate goal of the profession, that there will or may be intermediate steps in that process.
Licensure may be taken as a direct step or the process of certification and/or registration may be the intermediate steps to the ultimate goal of licensure. It is however noted that licensure is and should be the primary goal of the profession of exercise physiology.
Excerpt from Model for Licensure of Exercise Professionals … A Federal Report, entitled "A Proposal for Credentialing Health Manpower" (1977) recommends six criteria be used by state legislators to determine if a licensing bill is worthy of proceeding through the legislative process. The six criteria are as follows:
2. Current Programs and Differences of Emphasis
Benefits of Exercise Physiology program
3. Suggested Levels of Practice in Exercise Physiology
(a) Experimental Exercise Physiologists: These individuals have earned doctorate degrees in exercise physiology. They are the only group to be inferred the title of exercise physiologist. The work of these individuals is research-based and not "practicing" exercise physiologists. Most of these individuals work in a university setting and would only need licensure if they began "practicing" exercise physiology in a clinical setting.
(b) Wellness Consultant and/or Health/Fitness Instructor: A minimum professional preparation that consists of the following items.
(c) Clinical Exercise Physiologist (CEP): This individual has the following credentials to work in areas as indicated below.
Clinical Physiologist (CP): The scope of practice and credentials include the following items.
Administration, supervision, and interpretation of lab tests
Exercise prescription and supervision
Rehabilitation and health promotion
Education and counseling
Primary and Secondary Prevention
In conclusion, it is the purpose of this paper to state the position of the Louisiana Association of Exercise Physiologists for regulations by standards of practice and ultimately for licensure of the profession of exercise physiology.
The scope of practice for exercise physiologists has developed into a broad and diverse focus. It is the hope of this organization that by implementing some regulation and ultimately licensure that the standards of care will be enhanced and the safety of those individuals receiving treatment will remain protected. It is obvious by the materials presented that exercise physiology is not an adjunct to other forms of therapy, but is in fact an integral and separate component of therapy utilized in the overall management of individuals in the process of maintaining their health and wellness.
It is our positions that due to the growth of the profession of exercise physiology that there be a specific outlined educational program for each level of practice within the realm of exercise physiology. The levels of the profession targeted for regulation and licensure are those individuals in actual practice of exercise physiology, specifically the clinically and public/private setting.
It is not our purpose to exclude any individuals currently practicing from the licensure process or the regulations of the profession. It is our hope to impact those individuals who would be preparing for exercise physiology as a future profession. A grandfather clause would be utilized for all those individuals presently practicing within the profession.
Degree level, certification, and professional setting would differentiate the four levels of the profession of exercise physiology. It is strongly noted that regulation of the profession will bring about limitations, as well as uniformity to the profession. Ideally, licensure would give more definitive boundaries to the practice of exercise physiology and bring credibility to the title of clinical exercise physiologist and clinical physiologist.