Psychologist Carl Rogers believed that every person is naturally inclined to grow in a positive direction, not only for themselves but for society and their community. Rogers therefore suggested that it’s unhelpful and unnecessary to center a coaching or therapeutic relationship on telling, directing, and prescribing. When such relationships are grounded instead in authenticity, warmth, and empathetic understanding, patients are more likely to grow — and to stick with that growth. 

Authenticity — showing up as ourselves with the best of our personalities — may actually come quite easily to us, particularly as we enter into the later stages of our careers set on a firm foundation of competence and experience. And warmth is likely a strength of yours as well. After all, you entered this field because of your care for others and passion for their well-being. 

The healthiest approach for you and your patient is one that allows you to explore how the other person is feeling and acknowledge it — and to care about their situation without the “righting” or “fixing” reflex that can undermine their autonomy and make us feel emotionally bound up in their situation. 

By the way, this isn’t just about getting through empathy and on to the “real work” of goal-setting and action-planning. Empathy in health care providers actually leads to better clinical outcomes, better understanding of symptoms and more effective treatment plans. 

Research in the field of exercise oncology has created a large and consistent body of knowledge regarding the benefits of physical exercise throughout the cancer continuum. In this regard, several international organizations, in particular the American College of Sports Medicine® (ACSM), have published recommendations based on the existing evidence that justifies the need for appropriately programmed physical exercise for the prevention and management of cancer-related side effects such as fatigue, loss of function, or anxiety and depression. 

These recommendations were largely based on studies that included patients without metastases. The exercise effects in people with metastases have not yet been extensively studied, and these patients are often excluded from clinical trials. In this context, the EFFECT study (NCT04120298) was conducted at centers in Europe and Australia to assess the effects of physical exercise on quality of life, fatigue, and other side effects in people with metastatic breast cancer. The exercise program was structured, individualized, progressive, and supervised. The program duration was nine months and included balance, resistance, and aerobic training two days per week for the first six months and one day per week from the seventh to the ninth month. 

Over the course of the EFFECT study, we had a case, published in the October 2023 issue of Medicine & Science in Sports & Exercise®, of particular interest to exercise professionals. The case highlights the value of adding supervised exercise to the treatment of patients with metastatic disease. 

One of our participants, a 75-year-old woman, had regularly attended the training program under the direct supervision of the same physical trainer. During the seventh month of training, the trainer noticed some subtle changes in the patient’s motor function. For example, the patient displayed issues during balance exercises, and she required longer rest intervals or a reduction in load during aerobic training. Additionally, the loaded movements that she had previously mastered, such as the bench press, became more uncoordinated. The trainer also noticed the patient had a slightly slower eyelid movement. However, the patient did not seem concerned about the changes, and when the trainer suggested she discuss these changes with her oncologist, the patient’s own indifference delayed this. Suspecting brain metastases based on the patient’s subtle deterioration in neurological functioning, and with the patient's permission, the trainer herself spoke to the clinician, who immediately ordered an MRI scan, which confirmed the suspected brain metastases. 

The primary lesson of this case is that exercise trainers by the nature of their profession can detect small but important changes in motor function that patients, relatives, or clinicians themselves may not be able to detect in the early stages of brain metastases. This highlights the importance of proper qualification and education, especially for supervising people with diseases like cancer, and the advantages of supervised exercise training. At the same time, it is necessary to create adequate channels of communication between the patient, trainer, and clinician to ensure that relevant information is conveyed in a timely manner. Although early detection of brain metastases does not result in prolonged survival in every patient, for some patients this can be the case and for others early treatment might prevent further loss of quality of life. 

In summary, our case report adds another advantage to implementing supervised physical exercise as part of routine cancer care. It emphasizes the importance of skilled exercise trainers and the benefit of a close collaboration between the medical team and exercise professionals. 

Acknowledgements: The EFFECT study is part of the PREFERABLE project and received funding from the European Union’s Horizon 2020 research and innovation program (grant agreement No. 825677). The study is also co-funded by the National Health and Medical Research Council of Australia (2028/GNT1170698). 

Dr. Mireia Pelaez’s research focuses on the effects of physical exercise in special populations, specifically cancer (treatment-related side effects) and pregnancy (excessive weight gain and its consequences). She currently combines her teaching activity as an associate professor at the European University of the Atlantic in Santander, Spain, with her research activity as a project manager for GoNorte and freelance consultant. You can find Dr. Pelaez at Instagram or X: @mireia_pelaez.

Dr. Anne May is a professor of the clinical epidemiology of cancer survivorship and director of research at the Julius Center at the University Medical Center Utrecht in the Netherlands. She investigates the effects of lifestyle on treatment-related side effects and prognosis as well as in the underlying mechanisms, with a special emphasis on physical activity and exercise. Dr. May has served on lifestyle- and cancer-related guideline panels (ACSM/ASCO/WCRF) and is the principle investigator for several large national and international exercise RCTs, including Preferable (h2020preferable.eu) and Preferable II (preferable2.eu). You can connect with Dr. May at X: @annemariamay and follow PREFERABLE at X: @preferable_mbc.

In the ever-evolving world of exercise science, staying ahead of the curve is vital for both students and instructors. The American College of Sports Medicine (ACSM) has long been a trusted source of knowledge and standards in this field. In this blog post, we'll explore how Wolters Kluwer addresses various educational needs through our updated Lippincott^® Connect offerings, ensuring student success, instructor effectiveness and preparation for ACSM certification. 

Teaching to ACSM Standards 

One of the fundamental needs of educators and students in the realm of exercise science is access to trusted resources and standards. Wolters Kluwer and ACSM have you covered with a robust lineup of educational offerings. Lippincott^® Connect has evolved from an interactive eBook to a courseware solution, offering an all-in-one learning experience combining the eBook with multimedia content and assessment. Currently, there are two ACSM titles available with Lippincott^® Connect, with many more titles releasing on December 1st… including ACSM’s Guidelines for Exercise Testing and Prescription, 11th edition! See below for the full list of ACSM titles offered with Lippincott^® Connect. 

Ensuring Student Success 

Wolters Kluwer understands that student success is the ultimate goal, both in the classroom and beyond. To achieve this, we offer an array of products designed to provide instant feedback to students. This feedback, in the form of answer explanations and references to the book content, not only helps students understand where they went wrong but also encourages those who may be hesitant to seek extra help during office hours. With resources like quizzes, videos, video questions, and adaptive learning through PrepU for select titles, students have a wealth of interactive tools at their disposal. 

Support for Instructors 

Instructors play a pivotal role in guiding students toward success. Wolters Kluwer recognizes this and provides valuable tools for instructors to monitor and support student performance. With insight into student performance data, instructors can tailor their instruction and discussions more effectively. This information helps identify class-wide struggles and individual students who may be at risk. Instructors can then adapt their teaching strategies to address these challenges head-on. We also offer many instructor resources to accompany your course, including PowerPoint presentations for lectures, image banks and a sequestered bank of test questions, all designed to support instruction of the text. 

Preparation for ACSM Certification 

For students looking to pursue ACSM certification, we have integrated our certification books and Guidelines into our courseware (starting Dec 1). This integration streamlines the learning process, making it more convenient and accessible. Additionally, PrepU mastery level quizzes will be offered in ACSM’s Resources for the Personal Trainer, 6e, ACSM's Resources for the Exercise Physiologist: A Practical Guide for the Health Fitness Professional, 3e and ACSM's Resources for the Group Exercise Instructor, 2e. Lippincott^® Connect courseware also offers self-study options for those seeking certification outside of traditional classroom settings, ensuring that aspiring certified professionals can prepare at their own pace. 

Adapting to Various Teaching Needs 

Wolters Kluwer recognizes that instructors often teach multiple courses, each with its own unique requirements. To ease this burden, we offer a strong selection of instructor resources integrated into Lippincott^® Connect, aligned with each text. This integration allows for customization, enabling instructors to select what to assign, when and with what point values. It's a flexible approach that caters to instructors' diverse needs while still maintaining a cohesive learning experience. 

Catering to Diverse Student Groups 

Lippincott^® Connect’s instructor insight into student performance is a valuable tool for instructors dealing with classes of various sizes and students pursuing different career paths. This feature helps instructors gauge where each student stands academically and where the entire class may be struggling. It identifies students at risk and pinpoints the topics they find most challenging, allowing instructors to provide targeted support. 

ACSM and Wolters Kluwer’s commitment to meeting the diverse needs of both students and instructors in the field of exercise science is evident in this comprehensive range of resources and products. By offering trusted texts, tools for student success, certification preparation and support for instructors, ACSM continues to foster excellence in exercise science education. 

The following titles are currently available on Lippincott^® Connect: 

The ACSM Health & Fitness Summit and ACSM Regional Chapter meetings are great opportunities for exercise science and sports medicine students of all stripes, whether undergrad or graduate, to expand their horizons in their chosen field.  

But of course, it isn’t always easy to get students to commit to events like these. For one, students have busy schedules already, and adding something else to the calendar, especially something that requires travel and an overnight stay or two, can seem daunting.  

For another, it’s tough to miss out on your other courses. And then there are the financial considerations involved. 

But none of this is insurmountable. Faculty members Julia Buchanan, Ph.D., ACSM-EP^®, EIM and Zakkoyya H. Lewis Ph.D., ACSM-EP^®, EIM, offer up some helpful tips for getting your students onboard.  

1. Tie meeting attendance to one of your courses. At her university, Dr. Buchanan is able to offer a one-credit-hour special topics course. Counting toward elective credit, this course requires students to attend a meeting and then complete a suit of related assignments based on their conference experience. For her part, Dr. Lewis has students choose a topic to research further based on one of the presentations they attended. 

2. Provide a letter of absence for their other classes. Your students might feel intimidated by the idea of telling their other professors they’re going to miss class. Giving them a letter (on official letterhead) explaining why they’re going to be absent, where they’re going, and why it’s important for their educational trajectory can go a long way. 

3. Given them all the advance notice in the world. Some students are type A, on-the-ball people who jot down everything and constantly organize and reorganize their calendars. But many others are a little more lax. The earlier you can make your classes aware of an upcoming event — and continually remind them of its approach — the better. This isn’t just important for scheduling purposes — often, early registration confers benefits like reduced attendance fees. 

4. Hold an information session early in the semester. Instead of just mentioning the conference in class, it might be helpful to actually spend a chunk of time at the beginning of the semester talking about why these meetings are important — from the simple experience of seeing a professional conference to rubbing shoulders with peers and colleagues to actively making career-forwarding connections. 

5. Hold regular group meetings before the event. Dr. Buchanan notes, “Leading up to the conference, students must attend several group meetings that outline the course expectations and assignments that they will need to complete after the conference. The meetings also discuss expectations and tips for attending a professional conference (since this is a first for many of them). This is also a great way for the students to start to get to know one another before the trip.” 

6. Offset the cost of attendance. As stated in tip No. 3, getting the word out early about meetings can give your students a chance to take advantage of early bird registration savings. But there’s more you can do to make things affordable, from asking your department or the university at large if they would be able to cover some of the registration fees and travel costs, or provide university transportation. Another option is to see whether your program’s student org would be interested in fundraising. 

But once you’re at an event, or after you’ve attended one, what then? Drs. Buchanan and Lewis suggest a number of options. One, remember that this is also a marketing opportunity for your program — take photos and videos to showcase what your students experience. Sharing the highlights of your trip with ACSM, your colleagues, and your school is a great way to get noticed. 

Two, consider holding a recap session where students can share their take on the presentations they attended. You can even formalize this a bit. As Lewis notes, “After the conference, students were required to give presentations that summarized their experience at the conference. Establishing conference attendance as a course requirement forces students to take advantage of the opportunity to learn from and network with others in the field.” 

Hopefully you’ve found these tips helpful—we look forward to seeing you and your students at the next ACSM event! 

For more information, check out ACSM’s Meetings & Events page. 

Such pronouncements come in a number of distinct forms, all with their own unique development and review processes: position stands, umbrella reviews, expert consensus statements, contemporary issues, and calls to action. You can learn more about each of these pronouncement types on the ACSM website.  

This current pronouncement is an ACSM Expert Consensus Statement. These statements represent a combination of the available evidence on a particular subject and, as the name suggests, a consensus of expert opinion. ACSM reserves such pronouncements for subjects of high importance or wide-ranging impact. However, these pronouncements do not necessarily indicate policy recommendations. 

“The Biological Basis of Sex Differences in Athletic Performance: A Consensus Statement for the American College of Sports Medicine” aims, as the name likewise conveys, to share the most up-to-date knowledge available and an expert consensus about the biological reasons behind sex differences in athletic performance — particularly as athletic governing bodies debate policies regarding the inclusion of transgender athletes in cross-sex competition. This latter point is important to ACSM because the organization is dedicated to encouraging safe physical activity and sports participation for all people. Again, however, the statement’s purpose is not to make policy recommendations but rather survey the field to see what information might be available for, or necessary to include in, such a discussion. 

What does this statement include? 

The statement’s findings show that differences in performance between males and females are largely driven by males’ far greater production of testosterone beginning at puberty — roughly 12 years of age. In fact, by age 18, males on average have 15 times more testosterone in their bodies than females. Thus, adult males are faster, stronger and produce more power than females of approximately the same age and training. In athletic events that showcase or otherwise require aerobic capacity or muscle power, males outperform females by 10-30%. (Though this consensus statement does briefly cover some of the biological differences in children, its focus is almost entirely on adults.)  

The statement’s authors also note, however, that there is far less evidence about athletic performance in adult females than one might expect or, rather, hope for. Historically, and even today, much of the field has focused on the exercise physiology and performance of males, and more research centered on females could provide much-needed, actionable data from this relatively neglected population. The implications for the health and performance of female athletes could be profound, even beyond athletic competition. Such research would also be particularly timely as females enter, in increasing numbers, traditionally male professions that require physical prowess, including the military, law enforcement and firefighting. 

Regarding transgender issues, ACSM plans to publish two further pronouncements on the subject, “Clinical Care (health/performance) Issues of Transgender Athletes” and “Call to Action on the Need for More Research.” Both of these papers are currently in development. 

The authors point out that there are still many gaps in the current research regarding sex differences in athletic performance. They note particular opportunities for studies examining exercise performance and adaptations related to short- and long-term exercise, as well as exploration of different training and rehabilitation modalities for males and females. 

For additional resources on the consensus statement, please visit acsm.org/sd. 

Correction Note (Published 10/6/23)

The Consensus Statement Writing Group has corrected two errors identified in the original pronouncement published on Sept. 29. Both errors were found in the same statement in Box 1: Definitions.

Original Statement

Two percent of humans are intersex, harboring both male and female reproductive organs, and are reproductively fertile.

Corrected Statement

Differences/disorders of sex development (DSD) are rare conditions in which the development of chromosomal, gonadal, and anatomic sex is atypical (outside the binary of male/female).

Rationale for Corrections

This statement erroneously shared that “Two percent of humans are intersex..” The two percent figure represents the broadest range of conditions characterized by genital, reproductive, hormonal or sex chromosome differences, and includes many conditions that are not widely considered to be classified as DSD/intersex traits. The prevalence is much lower with narrower definitions of DSD/intersex. As a result, the two percent figure has been removed, the phrase corrected and the language is now consistent with the original corresponding sentence in the consensus statement itself (See page 19, under the heading “Hormonal Disorders (PCOS, DSD)”).

Additionally, the sentence incorrectly stated that individuals with DSD are “reproductively fertile.” Because some with DSD do experience infertility, the phrase was removed completely.

The Translational Journal of the American College of Sports Medicine will release an errata as soon as possible in order to ensure the published record is as accurate as possible.

Medicine & Science in Sports & Exercise will incorporate the corrected language into the final version of the consensus statement, which will appear in its December 2023 issue.