What is the therapeutic exercise profession?
The therapeutic exercise profession is a health care profession. Therapeutic exercise professionals are educated in anatomy, kinesiology, and biomechanics. Using this knowledge base, they can examine an individual’s current movement pattern to identify limitations in the body that might lead to injury or disease.
The main goal of treatment will be to maximize functional capacity by employing exercise. The health care professions of physical therapists, occupational therapists, and speech-language pathologists (among others) may also practice therapeutic exercise as part of their approach to treat disease or disability.
People who experience injury or illness typically benefit from therapeutic exercise, whether they are injured athletes trying to return to the sport they love, a child with cerebral palsy who experiences muscle spasticity.
An individual recovering from a stroke is trying to maximize the recovery of their lost functional capacity, or even someone trying to decrease their risk of developing cardiovascular disease.
Therapeutic exercise professionals are health care professionals who use their education and training (including knowledge, therapeutic skills, and critical reasoning) to prevent injury or improve function in individuals who have experienced disease, injury, or disability.
I know that therapeutic exercise professions are health care professions but what are their “core competencies”?
Health care professionals are typically educated in the significant fields of study within their profession (i.e., anatomy, kinesiology, physiology, pathology, etc.).
Along with their education, as health care professionals, they are also expected to possess “core competencies,” which are described as those knowledge, skills, and behaviors that professionals should have regardless of their setting.
Therapeutic exercise core competencies were defined by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) and the American College of Sports Medicine (ACSM).
These core competencies help define the unique roles that fall into this profession. The AACVPR and ACSM joint report presents a set of 7 core competencies which are described below:
1)Examine, interpret and integrate scientific knowledge related to health, fitness, and wellness in a manner applied to clinical exercise testing and prescription.
2)Apply knowledge of movement science, anatomy, kinesiology, and biomechanics to examine, evaluate, and intervene with individuals who have a disorder or disease process.
3)Design safe and effective therapeutic exercise programs that include warm-up, cool-down, stretching/flexibility training, and strengthening exercises based on the individual’s health and fitness status and specific health/fitness goals.
4)Integrate physical activity and exercise into therapeutic interventions for populations with cardiac, pulmonary, metabolic, and neuromuscular disease to improve functional capacity and quality of life.
5)Use appropriate testing procedures (e.g., cardiorespiratory, strength/resistance, flexibility) to evaluate an individual’s health status and identify areas of susceptibility or risk.
6)Evaluate the effects of therapeutic exercise interventions on physical activity routines and goals; cardiovascular, pulmonary, and metabolic fitness; neuromuscular function; lifestyle behaviors (e.g., eating habits, sleep patterns); and quality of life in individuals with heart/lung disease, metabolic disorders or neuromuscular conditions.
7)Establish therapeutic partnerships with diverse individuals to maximize their adherence to intervention goals by applying motivational interviewing techniques.
AACVPR is a professional association representing more than 4000 health care professionals who use exercise as a treatment for disease and illness. ACSM is a national organization and accrediting body for health and fitness professionals with more than 50,000 members in 100 countries worldwide.
The AACVPR/ACSM joint report summarizing the core competencies of therapeutic exercise professions has been endorsed by numerous professional organizations, including the American Academy of Pediatrics, American Council on Exercise, the American Dietetic Association, the American Heart Association, National Athletic Trainers’ Association, and the YMCA of the USA.
You mentioned that therapeutic exercise professionals play a significant role in cardiac rehabilitation.
I know they prescribe and direct exercise activities to improve functional capacity and quality of life for those with cardiovascular problems, but what is their treatment philosophy?
Well, therapeutic exercise professionals would typically use a “classical conditioning” approach to improve cardiovascular function and reduce the risk of heart disease.
This type of rehabilitation would include activities designed to increase an individual’s work capacity through a progressive training regimen. For optimal results, this training program should be monitored by a professional who has experience working with cardiac patients.
As for the treatment of other health problems, therapeutic exercise professionals typically use an “instrumental conditioning” approach to improve physical performance and reduce the risk or delay of disability associated with many severe diseases like diabetes, end-stage renal disease (ESRD), chronic obstructive pulmonary disease (COPD), cancer, arthritis and more.
For example, a comprehensive physical activity program for patients with arthritis should include activities that will improve functional abilities, so they can manage their disease and maintain an active lifestyle. These programs are often monitored by specially trained professionals working with this patient population.
On average, how long are sessions?
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That depends on the type of program being delivered to the patient. For example, sessions in a cardiac rehabilitation setting tend to last up to 60-75 minutes, while exercise prescription for therapeutic fitness may involve two to three sessions per week over 10-20 weeks.
On the other hand, weight management programs (i.e., lifestyle intervention) typically involve multiple contact points during treatment, and each session is scheduled accordingly.