Spotlight on: Clinical exercise physiology

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Each month Fitness Journal puts the spotlight on a health profession or treatment. This month Wintec’s Stephen Burden explains Clinical Exercise Physiology.

What is it?
Greg Smith, centre director at Wintec’s Centre for Sport Science and Human Performance recently stated “our NZ population is ageing; we have the third highest adult obesity rate in the OECD and our rates of chronic diseases are rapidly increasing.

The benefits of exercise as both a preventative and rehabilitative treatment to chronic illnesses such as diabetes, obesity, cardiovascular disease, respiratory disease or chronic pain and injury are huge and this knowledge can bring with it big opportunities for New Zealanders.

Clinical Exercise Physiology is a new field of health in New Zealand, specifically dedicated to this. It has been a registered health profession in countries all around the world for many years, in the United States, UK, South Africa and Australia, but it is only just emerging in New Zealand.

To work in this area requires knowledge not only of exercise, but of the diseases and illnesses that exercise is applied to. The Clinical Exercise Physiology New Zealand (CEPNZ) board is in the process of pushing through the registration for this profession.

Very soon, clinical exercise physiologists will become part of the allied health workforce meaning they’ll sit alongside health professionals such as physiotherapists, occupational therapists and social workers.

What is a Clinical Exercise Physiologist (CEP)?
A Clinical Exercise Physiologist (CEP) is an individual who specialises in the delivery of exercise, lifestyle and behavioural modification programmes for the prevention, management and rehabilitation of chronic diseases, and musculoskeletal injuries.

•  A CEP provides individualised and specialised exercise and lifestyle education for clients across a wide spectrum of health, from the apparently healthy to those with diagnosed conditions such as cardiovascular disease, diabetes, respiratory disease, or chronic pain and/or injury.

•  A CEP evaluates and measures: posture, body composition, blood pressure, glucose and cholesterol levels, lung function, heart rate and ECG, fitness, muscle strength, endurance, power, flexibility and other health screening tests.

•  The CEP plays an important role in a multi-disciplinary team by providing specialised exercise testing, exercise programming and client education (within their professional scope of practice) in conjunction with other medical and allied health professionals.

•   In the New Zealand context there is under the Treaty of Waitangi a commitment to Maori Health, and Pacific Health and the multi-cultural NZ population.

What is involved to become qualified to offer this treatment?
A graduate with a Bachelor’s degree in Sport & Exercise Science, needs to complete a Postgraduate Diploma in Clinical Exercise Physiology. During the Post Graduate Diploma year a 500 hour internship must be completed to meet the guidelines for accreditation as a CEP. Training programmes are offered at Winte,; Auckland University and Universal College of Learning (UCOL, Palmerston North).

Who regulates it?
CEPNZ  has a governance group (the CEPNZ Board) that is working to establish a professional community of like thinking Clinical Exercise Physiologists, or other interested parties, that have a vested interest in growing this discipline area.

Who can it help?
Clinical Exercise Physiology is for everybody – young, old, athletic or mobility-challenged. There are no limitations to who can benefit from treatment, as prescription programmes and assessment methods can be adjusted to meet the needs of just about anyone.  In post-operative injury cases, the CEP will provide a final-phase exercise rehabilitation programme to restore the individual to full function.

What is it most commonly used for?
Clinical Exercise Physiology doesn’t have a ‘typical’ client, it really is for everybody.

What is the average cost per treatment?
The profession has no set guidelines, so rates vary nationwide.

What are the most common misconceptions?
CEPs should be seen as registered health professionals; not personal trainers.

How and why did you get involved?
I completed my Biokinetic internship in South Africa from 1990-1992 and moved into private practice in 1993.

My primary focus was in cardiac rehabilitation (programme coordinator of the Western Cape Heart Foundation Cardiac Rehab Programme) and musculoskeletal injuries (orthopaedic and sports injuries) In 1997, I joined the University of Zululand staff to educate and train future biokineticists.

I was offered a position at Wintec to lecture injury prevention and exercise rehabilitation, so moved to New Zealand in July 2000. The word Biokinetics is not used in New Zealand; but an emerging profession called Clinical Exercise Physiology is essentially the same.

Clinical Exercise Physiology New Zealand (CEPNZ) was established in 2012 to advocate for and promote the emerging Allied Health Workforce of Clinical Exercise Physiology (CEP) in New Zealand. We currently have 80 members and this is growing fast.

A key outcome of CEPNZ is to establish a nationally recognised CEP Accreditation pathway that also has international portability. I was appointed to the CEPNZ Board in 2015 and together with Dr Glynis Longhurst, run the Wintec Biokinetic Clinic and teach on the PG Diploma in Clinical Exercise Physiology programme.

Stephen Burden is a Wintec lecturer around injury prevention and exercise rehabilitation.He is also a board member of Clinical Exercise Physiology New Zealand (CEPNZ) and runs the Wintec Biokinetic Clinic with Dr Glynis Longhurst, as well as teaching the PG Diploma in Clinical Exercise Physiology programme.

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