Bridging the gap between clinicians and fitness professionals

Objective Health clubs (HC) and personal trainers (PT) are traditional outlets for the promotion of physical activity (PA) and exercise programming. As physicians are increasingly being called on to write exercise prescriptions for their patients, this study sought to investigate the level of integration between the healthcare and fitness systems. Design An internet study was designed with five domains to understand physicians’: (1) overall perception of HC, (2) appropriateness and recommendation of HC and PT to their patients, (3) attitude regarding specific aspects of HC, (4) support of patient participation in HC sponsored exercise and (5) elements of HC that physicians would like to know for referral. Methods An electronic survey was sent to members of two mailing lists of primary care and sports medicine specialty physicians during 2011–2012. Results On a Likert scale of 1–10 412 physicians reported being familiar with HC (8.9±2.1), indicated a favourable view of HC (7.9±2.2), and believe HC to be an appropriate venue for their patients (7.5±2.3). However, physicians only recommend HC to 41%±28% of their patients and PT for only 21%±21.6% of patients. Physicians ranked expense and convenience as the most problematic elements of HC (8.1±2.1 and 6.3±2.5, respectively). 72% of physicians indicated cost as most concerning when recommending a specific HC. Conclusion HC and PT are a significant implementation system for the promotion of physical activity, yet physicians are concerned with several elements of HC and are not adequately relying on this partnership to promote physical activity to their patients

Exercise professional education, qualifications, and certifications: a content analysis of job postings in the United States

IntroductionGrowth in the field of clinical exercise science and the potential impacts on overall health and wellbeing have driven the need for qualified, clinically trained, exercise professionals. And yet, it is not well understood what specific credentials employers are seeking when hiring exercise professionals.PurposeThe purpose of the study was to examine the qualification requirements for professionals seeking employment in exercise science, exercise physiology, kinesiology or equivalent fields.MethodsSearch platforms Indeed.com and USAJobs.gov were examined within a two week period in 2022. Search terms included “Exercise Physiology”, “Exercise Science”, “Exercise Professional”, “Exercise Prescription”, “Exercise Specialist”, and “Kinesiology”.ResultsA total of n = 739 jobs were retrieved and n = 615 jobs were included: Exercise Science (n = 227), Kinesiology (n = 210), Exercise Physiology (n = 91), Exercise specialist (n = 53), and Exercise prescription (n = 32). Over 70% of the jobs analyzed required a bachelor's degree with the remainder requiring various levels of education. The primary certification required was personal trainer (n = 94), followed by strength and conditioning specialist (n = 33), clinical exercise physiologist (n = 26), group exercise (n = 17), exercise specialist (n = 10), and exercise physiologist (n = 5). Four job focus areas were determined: academic teaching and research, general fitness and worksite wellness, athletic performance and rehabilitation, clinical exercise specialist all with varying levels of degree and certification requirements.DiscussionJob postings related to exercise related professions are varied across the United States with wide-ranging education, credentialing and certification requirements. These findings indicate the timely need for outreach to employers to highlight changing credentialing requirements due to evolving accreditation standards

Including lifestyle medicine in undergraduate medical curricula

Purpose Currently, there is no model to integrate the discipline of lifestyle medicine (LM) into undergraduate medical education. Furthermore, there are no guidelines, validated assessment tools, or evaluation or implementation plans in place. Background: The World Health Organization predicts that by 2020, two-thirds of disease worldwide will be the result of poor lifestyle choices. Fewer than 50% of US primary care physicians routinely provide specific guidance on nutrition, physical activity, or weight control. Methods: We are establishing a plan to integrate LM into medical school education in collaboration with the investing stakeholders, including medical school deans and students, medical curriculum developers and researchers, medical societies, governing bodies, and policy institutes. Three planning and strategy meetings are being held to address key areas of focus – with a particular interest in nutrition, physical activity, student self-care, and behavior change – to develop specific implementation guidelines and landmarks. Results: After the first two meetings, the proposed areas of focus were determined to be: 1) supporting of deans and key personnel, 2) creation of federal and state policy commitments, 3) use of assessment as a driver of LM, 4) provision of high-quality evidence-based curricular material on an easily navigated site, and 5) engaging student interest. Implementation strategies for each focus area will be addressed in an upcoming planning meeting in early 2015. Conclusion: This initiative is expected to have important public health implications by efficiently promoting the prevention and treatment of non-communicable chronic disease with a scalable and sustainable model to educate physicians in training and practice

Age-congruency and contact effects in body expression recognition from point-light displays (PLD)

Recognition of older people's body expressions is a crucial social skill. We here investigate how age, not just of the observer, but also of the observed individual, affects this skill. Age may influence the ability to recognize other people's body expressions by changes in one's own ability to perform certain action over the life-span (i.e., an own-age bias may occur, with best recognition for one's own age). Whole body point light displays of children, young adults and older adults (>70 years) expressing six different emotions were presented to observers of the same three age-groups. Across two variations of the paradigm, no evidence for the predicted own-age bias (a cross-over interaction between one's own age and the observed person's age) was found. Instead, experience effects were found with children better recognizing older actors' expressions of `active emotions,' such as anger and happiness with greater exposure in daily life. Together, the findings suggest that age-related changes in one own's mobility only influences body expression categorization in young children who interact frequently with older adults

Ageing, Muscle Power and Physical Function: A Systematic Review and Implications for Pragmatic Training Interventions.

BACKGROUND: The physiological impairments most strongly associated with functional performance in older people are logically the most efficient therapeutic targets for exercise training interventions aimed at improving function and maintaining independence in later life. OBJECTIVES: The objectives of this review were to (1) systematically review the relationship between muscle power and functional performance in older people; (2) systematically review the effect of power training (PT) interventions on functional performance in older people; and (3) identify components of successful PT interventions relevant to pragmatic trials by scoping the literature. METHODS: Our approach involved three stages. First, we systematically reviewed evidence on the relationship between muscle power, muscle strength and functional performance and, second, we systematically reviewed PT intervention studies that included both muscle power and at least one index of functional performance as outcome measures. Finally, taking a strong pragmatic perspective, we conducted a scoping review of the PT evidence to identify the successful components of training interventions needed to provide a minimally effective training dose to improve physical function. RESULTS: Evidence from 44 studies revealed a positive association between muscle power and indices of physical function, and that muscle power is a marginally superior predictor of functional performance than muscle strength. Nine studies revealed maximal angular velocity of movement, an important component of muscle power, to be positively associated with functional performance and a better predictor of functional performance than muscle strength. We identified 31 PT studies, characterised by small sample sizes and incomplete reporting of interventions, resulting in less than one-in-five studies judged as having a low risk of bias. Thirteen studies compared traditional resistance training with PT, with ten studies reporting the superiority of PT for either muscle power or functional performance. Further studies demonstrated the efficacy of various methods of resistance and functional task PT on muscle power and functional performance, including low-load PT and low-volume interventions. CONCLUSIONS: Maximal intended movement velocity, low training load, simple training methods, low-volume training and low-frequency training were revealed as components offering potential for the development of a pragmatic intervention. Additionally, the research area is dominated by short-term interventions producing short-term gains with little consideration of the long-term maintenance of functional performance. We believe the area would benefit from larger and higher-quality studies and consideration of optimal long-term strategies to develop and maintain muscle power and physical function over years rather than weeks

Lifestyle Medicine Education

The actual causes of premature adult deaths, the preponderance of noncommunicable chronic diseases, and their associated costs are related to unhealthy behaviors, such as poor nutrition, physical inactivity, and tobacco use. Although recommended as the first line of prevention and management, providers often do not provide behavioral change counseling in their care. Medical education in lifestyle medicine is, therefore, proposed as a necessary intervention to allow all health providers to learn how to effectively and efficiently counsel their patients toward adopting and sustaining healthier behaviors. Lifestyle medicine curricula, including exercise, nutrition, behavioral change, and self-care, have recently evolved in all levels of medical education, together with implementation initiatives like Exercise is Medicine and the Lifestyle Medicine Education (LMEd) Collaborative. The goal of this review is to summarize the existing literature and to provide knowledge and tools to deans, administrators, faculty members, and students interested in pursuing lifestyle medicine training or establishing and improving an LMEd program within their institution

Translating Urban Walkability Initiatives for Older Adults in Rural and Under-Resourced Communities

The built environment can promote physical activity in older adults by increasing neighborhood walkability. While efforts to increase walkability are common in urban communities, there is limited data related to effective implementation in rural communities. This is problematic, as older adults make up a significant portion of rural inhabitants and exhibit lower levels of physical activity. Translating lessons from urban strategies may be necessary to address this disparity. This review examines best practices from urban initiatives that can be implemented in rural, resource-limited communities. The review of the literature revealed that simple, built environment approaches to increase walkability include microscale and pop-up infrastructure, municipal parks, and community gardens, which can also increase physical activity in neighborhoods for urban older adults. These simple and cost-effective strategies suggest great potential for rural communities

The Benefits of Physical Activity for People with Obesity, Independent of Weight Loss: A Systematic Review

Purposeful weight loss continues to be the primary focus for treating obesity. However, this strategy appears to be inadequate as obesity rates continue to rise and a myriad of benefits of physical activity that affect multiple health outcomes related to obesity and associated comorbidities are not integrated into treatment strategies. There are emerging correlational data in individuals with obesity that demonstrate physical activity can be beneficial to many critical health markers, independent of weight loss or changes in BMI. This systematic review investigates interventional studies that examine health markers, independent of weight loss, in individuals with obesity. Fourteen studies were identified that utilized a variety of physical activity interventions with primary endpoints that included cellular, metabolic, systemic and brain health outcomes. The review of the literature demonstrates that for individuals with obesity, there are both small-scale and large-scale physiologic benefits that occur with increased physical activity of various modalities. Focusing on these benefits, rather than a narrow focus of weight loss alone, may increase physical activity behavior and health for individuals with obesity