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The Role of an Accredited Exercise Physiologist

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What is ESSA?

 

ESSA (Exercise and Sports Science Australia) is the national advocacy, accrediting and membership body for Exercise Physiologists.

AEP’s were granted status as a Medicare provider in 2005.

This was followed by recognition of the compensable services under Workcover, DVA, and private health insurers.

Part of the allied health system for management of chronic disease and injury.  More opportunity lies in preventive health.

Physiology refers to the functioning of the body, cells, muscles, connective tissue, organs, bones, blood.  In many and varied ways exercise creates change in these components and exercise physiologists harness these changes and effects through exercise.

To date the combination of complex changes cannot be replicated in a drug so we say “Exercise is the Best Medicine”.

The list of conditions is long where good evidence exists of the benefits of exercise. This covers musculo-skeletal, metabolic, cardiorespiratory, neuromuscular, cancer, depression and certain mental health conditions.

We refer to an exercise prescription as for a particular type of exercise, and a dose in terms of the intensity, duration and frequency.  FITT principle (frequency, intensity, time, type).

What Services can an Accredited Exercise Physiologist Provide?

 

  • Exercise testing
  • Rehabilitation (Musculoskeletal, cardiac, respiratory)
  • Chronic disease management
  • Mental health
  • Cardiac stress testing
  • Strength & conditioning
  • Elite athletes
  • Research
  • Education
  • Motivational and lifestyle advice

Medicare under EPC provides for Ex Phys as one of, or all 5 annual sessions.  [at risk of developing] or with chronic disease.  Ex Phys and Dietician have 2 additional item numbers for Diabetes 2 related group exercise, and assessment for group exercise.

Physical activity guidelines are easy to achieve but minimum PA not being met by a large population.

For the General public, a lot of misinformation, confusion, lack of knowledge.  A sporting youth does not equate or translate into later years of exercising for health maintenance.

Accredited Exercise Physiologist Assessment

 

History, objective measures eg HR/BP, exercise response test, strength, function specific to goal, tasks or injury, meeting PA guidelines, Stages of Change, barriers to exercise/maintenance, Motivational Interviewing.

Create short, medium, long-term goals and an Ex Rx will be devised.

Emphasis is on self-management, however supervised exercise will be required in many cases of dementia, mental health, stroke, cancer, resistance training.  Exercise should be safe and effective, and progressive for long-term success.

 

Some useful websites:

https://www.essa.org.au/essa-me/about-us/ourmembers/how-can-an-accredited-exercise-physiologist-help/
https://www.essa.org.au/wp-content/uploads/2015/09/Scope-of-Practice-for-AEP.pdf
https://www.essa.org.au/for-gps/
https://www.essa.org.au/wp-content/uploads/2017/05/When-to-refer-to-an-aep-dl-flyer.pdf

Exercise Right is an initiative of ESSA directed at consumers with topical updates and blogs on the right way to exercise for the athlete to the deconditioned and unwell.

http://exerciseright.com.au/

Exercise is Medicine (EIM) is supported by ESSA and linked to the United States EIM campaign and ACSM. It is directed at GP’s and allied health providers to ensure at least one question in a consult about minimum physical activity. Link below to a provider action guide to help with this. Website is also a great resource for fact sheets on conditions and how exercise can help in each case. The quote below is from the Exercise is Medicine website.

http://exerciseismedicine.com.au/healthcare-providers
http://exerciseismedicine.com.au/wp-content/uploads/2016/11/Health-care-provider-action-guide_2016.pdf

“The message is simple. Exercise is the best, cheapest, most accessible medicine available and in order to improve chronic disease mortality rates, people need to move more. Each patient encounter is an opportunity for you to make a difference. Brief interventions in primary care settings are an effective way of increasing physical activity among adults. The Global Advocacy for Physical Activity supports the use of brief interventions linked to community based support for behaviour change. Several barriers have been identified as restricting the uptake of physical activity behaviour change in primary health care including; lack of specific knowledge and skills necessary to assess and prescribe physical activity behaviour change; time limitations; lack of confidence in skills necessary to support physical activity interventions; and perceived lack of interest by patients. The Exercise is Medicine Australia Framework has been developed with the time-pressured nature of general practice in mind, and is designed to provide the relevant resources quickly and easily.

Exercise is Medicine® is a global initiative, managed in Australia by Exercise & Sports Science Australia (ESSA).
EIM is focused on encouraging health care providers, regardless of specialty, to review and assess every patient’s physical activity levels at every visit. Patients should be counselled on physical activity, and provided with an exercise prescription or referral to an accredited exercise physiologist or appropriately qualified allied health professional.

The EIM initiative aims to make physical activity and exercise a standard part of a disease prevention and treatment medical paradigm in Australia. The initiative and resultant projects are designed to improve the health and well-being of all Australians through regular physical activity prescription from a range of clinicians including General Practitioners, nurses and other allied health providers”.

Image from Exercise Right

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