{"id":24774,"date":"2019-10-01T11:00:06","date_gmt":"2019-10-01T18:00:06","guid":{"rendered":"https:\/\/medfitnetwork.org\/public\/?p=24774"},"modified":"2021-05-14T09:36:48","modified_gmt":"2021-05-14T16:36:48","slug":"scope-of-practice-in-the-medical-fitness-field","status":"publish","type":"post","link":"https:\/\/medfitnetwork.org\/public\/all-mfn\/scope-of-practice-in-the-medical-fitness-field\/","title":{"rendered":"Scope of Practice in the Medical Fitness Field"},"content":{"rendered":"

\"\"I am reading a recent article by Jonathan Mike (in PFP Winter 2019 issue<\/a>) regarding scope of practice for personal training.\u00a0 I feel that I should respond to this for a couple of reasons \u2013 first to add some clarity to his foundation of SOP in wellness, and second, because I have published on this issue since 1991, so I feel I have some history and expertise in the area.<\/p>\n

My first stab at scope of practice was for clinical exercise physiologists in the late 1980s.\u00a0 I had worked in a medical research institute applying my skills as a personal trainer to groups of diabetic patients \u2013 type 1, type 2, and gestational.\u00a0 Problem was \u2013 little to no data on the effects of aerobic machines, strength training, or FITT principles on diabetic control or safety was published at that time.\u00a0 Thus \u2013 the scope of practice for exercise and diabetes was born.\u00a0 About four years later, I was developing one of the nation\u2019s first exercise programs for cancer survivors.\u00a0 Outside of the preliminary work of the late Meryl Winningham \u2013 no health club\/strength\/progression data on this group existed either.\u00a0 So \u2013 the scope of practice for exercise and cancer was born as well.<\/p>\n

My point here is that scope of practice should follow guidelines \u2013 and judging by the references below, there are lots of guidelines from many credible organizations, there still is an individual slant on how any exercise is programmed and prescribed.<\/p>\n

However, as the era of medical fitness comes into its own, the issue of scope of practice (SOP) is being written about in various periodicals and blogs.\u00a0 I would like to weigh in from a historical and common-sense perspective, in hopes of allowing individual trainers, business owners, and club management to understand what\u2019s going on in this space is it continues to grow.<\/p>\n

Thirty years ago, trainers were looking to physical therapy as a \u201ccomparison\u201d as to what they do.\u00a0 Various SOP documents and licensure laws popped up in California, Maryland, and Louisiana.\u00a0 Let\u2019s start with scope of practice.\u00a0 One of the finest versions of SOP was written by the late Dr. Mel Siff in 1988 in the Journal of Personal Training.\u00a0 He listed all of the elements of training in document that was over six pages in length.\u00a0 It has not been replicated to such an extent over many years.\u00a0 However, it outlines the practical applications of safe and effective personal training without laying out a specific game plan for personal training.\u00a0 This is a key element of proper programming in any aspect of the fitness profession \u2013 not to dictate the type of exercise, but the health, sports, or medical outcomes you are seeking from your clientele.\u00a0 Personal training scope of practice is highlighted in many of the references below \u2013 but the main aspects include proper and progressive exercise, safety (always), and proper outcomes via regular assessments, surveys, and training regimes.\u00a0 This has sadly been one of the most misunderstood and least applied aspects to how training is performed.\u00a0 However \u2013 that is changing.<\/p>\n

\"\"<\/p>\n

A recent report from Marshall and Groves looks at the effect of health club medically-based training programs on six different conditions.\u00a0 This is a landmark study for the health club profession, and should stand as the first study of its kind that looks at health outcomes within the club setting.\u00a0 One of the issues in the Marshall study is that all groups of medical conditions were given the same standardized exercise prescription from the staff.\u00a0 I\u2019m not sure why \u2013 because there are studies that show the benefits of both aerobic conditioning and strength training for cancer survivorship \u2013 either used together or separately.\u00a0 The outcomes were enhanced strength, endurance, quality of life, reduced fatigue and pain levels, and reduced medical interventions.\u00a0 All tremendous outcomes \u2013 independent of the type of exercise applied.\u00a0 This is true of yoga and Pilates \u2013 both of which fall out of a traditional \u201csports medicine\u201d exercise prescription, but both of which have a high level of improvement in physical function, and reduced medical interventions based on their use.<\/p>\n

Scope of practice in personal training will always be a much-discussed topic.\u00a0 And it\u2019s a good thing.\u00a0 Trainers like Jonathan Mike are wanting the profession to be looked at with respect.\u00a0 I don\u2019t blame him.\u00a0 As a watchdog for the industry \u2013 he will get professionals talking (like in this article), and more importantly \u2013 thinking.\u00a0 About how they can do what they do better \u2013 to attract more clients, but to keep their current clients fit, safe, and healthy.<\/p>\n

\n

Eric Durak is President of Medical Health and Fitness.\u00a0 He is on the advisory board for MFN.\u00a0 He worked as a personal trainer for over 20 years, starting in the mid- 1980s, and is one of the first in the health industry to apply personal training to diabetes care, pregnancy, and cancer survivorship.\u00a0 Contact Eric at <\/em>edurak@medhealthfit.com<\/em><\/a>.<\/em><\/p>\n

 <\/p>\n

References<\/strong><\/p>\n

Mike, J.\u00a0 Blurred Lines.\u00a0 Personal Fitness Professional<\/strong>.\u00a0 Winter, 2019.\u00a0 Pg. 18-19.<\/p>\n

Siff, M.\u00a0 Scope of practice in the fitness profession.\u00a0 Journal of Sports Science<\/strong>, 1983, pg. 2-19..<\/p>\n

Marshall, TF, Groves, JR, Holan, GP, et all.\u00a0 Feasibility of Community-based Supervised Exercise Programsto Engage and Monitor Patients in the Post Rehabilitative Setting.\u00a0 Am. J. Lifestyle Medicine<\/strong>.\u00a0 Jan. 2018.\u00a0 https:\/\/doi.org\/10.1177\/1559827617750385<\/a><\/p>\n

http:\/\/practice-center.com\/2015\/06\/scope-of-practice\/<\/a><\/p>\n

https:\/\/www.fitnessmentors.com\/chapter-1-role-and-scope-of-practice-for-the-personal-trainer\/<\/a><\/p>\n

http:\/\/www.becomingatrainer.com\/personal-training-scope-of-practice\/<\/a><\/p>\n

https:\/\/www.ideafit.com\/fitness-articles\/personal-training\/personal-training-ethics-scope-of-practice<\/a><\/p>\n

https:\/\/www.nsca.com\/education\/articles\/ptq\/a-swot-analysis-of-the-scope-of-practice-for-personal-trainers\/<\/a><\/p>\n

http:\/\/www.trainerexam.com\/chapter-1-role-and-scope-of-practice-for-the-personal-trainer\/<\/a><\/p>\n

https:\/\/drjohnrusin.com\/manual-thearpy-personal-trainer-scope\/<\/a><\/p>\n

https:\/\/journals.lww.com\/acsm-healthfitness\/Fulltext\/2012\/01000\/The_Legal_Aspects__Scope_of_Practice.10.aspx<\/a><\/p>\n

https:\/\/journals.lww.com\/acsm-healthfitness\/FullText\/2015\/07000\/Current_Perspectives_About_Scope_of_Practice.11.aspx<\/a><\/p>\n

https:\/\/journals.lww.com\/acsm-healthfitness\/Abstract\/2019\/03000\/CONNECTING_HEALTH_CARE_AND_HEALTH_AND_FITNESS.6.aspx<\/a><\/p>\n

https:\/\/www.researchgate.net\/publication\/288327851_The_scope_of_practice_for_the_personal_trainer<\/a><\/p>\n

https:\/\/www.livestrong.com\/article\/13716107-fitness-cant-just-be-for-the-rich-these-organizations-are-making-fitness-accessible-to-low-income-americans\/<\/a><\/p>\n

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