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Guidelines for exercise prescription

There are many well-established health benefits to participating in regular exercise, and although it is important that all individuals are encouraged to do so, there are a large number of people who are at risk of adverse events, or who may require safe exercise parameters given their health condition when attempting to do this. Additionally, exercise recommendations for individuals with established health conditions are rather vague, with moderate intensity aerobic exercise (i.e. 40-60% VO2R/HRR) being suggested as the recommended intensity to engage in physical activity. While this is a good public health message, it doesn’t provide any specific guidance for individuals who are unfamiliar with exercise programming and can mean that an individual is not performing the most effective exercise possible for not only overall health, but also the management of their given health conditions.

This is where the role of a Clinical Exercise Physiologist (CEP) is extremely important. CEP’s specialise in the delivery of exercise, lifestyle and behavioural modification programmes for the prevention, management and rehabilitation of chronic conditions, diseases, and injuries. Initially, some form of exercise testing (e.g. VO2max testing, muscular strength and/or endurance, flexibility etc.) will be performed with a client in order to establish an individual’s physiological response to exercise at given intensities, as well as identify areas of physical function that may require improvement. This will then form the basis of exercise prescription, providing the client with safe parameters for exercise and improvement of overall health and well-being. CEP’s will also monitor the client when they are performing this exercise in order to ensure that client safety is paramount and that safe progression of exercise intensity is implemented where appropriate.

An individualised combination of both aerobic and resistance training is important in the management of many health conditions. For example, aerobic exercise is important in overweight individuals with Osteoarthritis in order to decrease overall fat mass and reduce loading through the affected joint. Resistance training is also extremely important in order to strengthen weaker affected areas in order to improve mobility, pain and function, as well as reduce risk of further injury. Similarly, combined aerobic and resistance training improves insulin action and assists in the management of blood glucose levels, lipids, blood pressure and cardiovascular disease risk in type 2 diabetics.

Specific recommendations for exercise given an individual’s health condition(s) are important not only for safety reasons, but also to ensure that an individual is performing the most effective exercise they can given their goals and current health status. In order to ensure this, a qualified professional such as a CEP should oversee this process.