Clinical Exercise Physiology is a branch of Exercise Physiology that emphasizes the prevention and rehabilitation of heart, lung, and metabolic health conditions. Clinical Exercise Physiologists (CEP’s) generally operate under the oversight of a doctor in a medical center or clinical facility and are an important component of the entire preventive medicine staff.
This group can consist of physicians, nurses, dieticians, physical and occupational therapists, psychologists and social workers. Every personnel should be in CPR and Advanced Cardiac Life Support (ACLS). AED’s should be readily available and a complete emergency strategy should be in position, particularly if the facility is not inside an actual hospital setting.
Why Cardiac Rehabilitation Is Important
The primary work role for a CEP is in the area of cardiac rehabilitation. This is a clinically monitored medical facility-based program for patients who have had a heart attack or myocardial infarction, coronary artery bypass graft (CABG) surgery, Percutaneous transluminal coronary angioplasty (PTCA) (stent positioned in a coronary artery), or those with ongoing stable angina or chest pain, congestive heart failure, and those awaiting or coming from a heart transplant operation. The ultimate purpose of cardiac rehabilitation is to greatly improve a patient’s long-term results and quality of life. To carry this out, the team should emphasize an overall holistic approach, including the patient’s physical health (involving his or her degree of physical exertion), their emotional well being, and their social intercommunications with people surrounding them.
Inpatient Cardiac Rehab (Phase I)
Inpatient or Phase I cardiac rehabilitation takes place inside the hospital and starts right after a cardiac occurrence (i.e. myocardial infarction) or operation (i.e. coronary bypass). The first tasks the Clinical Exercise Physiologist will be facilitating during this period involve assisting the patient in sitting and standing up without support, in an effort to help them walk independently, so the patient will be able to be released from the medical center. In addition, an at-home walking plan can be explained before discharge and arrangement for the patient to start outpatient Cardiac Rehabilitation can be emphasized as well.
Outpatient Cardiac Rehab (Phases II - III)
Outpatient cardiac rehabilitation programs are usually found in certain hospitals, hospital-affiliated clinics, or even some fitness establishments. Patients can start as soon as 1 to 2 weeks following discharge. The objective of any outpatient program should be to help the patient in carrying out a risk-free and productive exercise and daily habits modification program. This should allow the patient to go back to work, return to their leisure activities, and those daily activities that could be very challenging immediately following their cardiac experience or surgery. Oversight and observation are vital during this period to ensure there aren’t further cardiac complications that may hinder their progression. Unobstructed communication among the personnel and the health care team is necessary to determine and subsequently treat any issues before they turn into more more severe conditions. Education is essential in helping the patient and his or her loved ones know ways to change their cardiovascular disease risk factors to effectively prevent or keep at bay the governing heart disease.
Certifications for Working in Cardiac Rehab
The American College of Sports Medicine (ACSM) has a couple of clinical certifications that are highly recommended for exercise physiologists interested working in a cardiac rehabilitation program or other clinical capacity, such as pulmonary rehabilitation. The Certified Clinical Exercise Specialist (CES) certification is for students with a Bachelor’s in Exercise Science or a related major, while the Registered Clinical Exercise Physiologist (RCEP) is made available to individuals with a Master’s degree in Exercise Physiology or area related to Exercise Science and 600 hours of clinical experience. For more information on these certifications, please see the ACSM Certification website.
