During their undergraduate academic careers, students majoring in exercise science-related fields contemplate various career paths and often seek guidance regarding the necessary steps to begin their career upon graduation. It is common to encounter soon-to-be graduates who want to work in the fitness industry but are confused about the wide breadth of certifications currently available. 

Who

The ACSM Certified Exercise Physiologist® (ACSM-EP) certification is ideal for those who want to work with generally healthy populations, and potentially clinical populations in the future. Most importantly, the ACSM-EP certification recognizes the certified professional’s educational background. All certified EPs must possess a bachelor’s degree in kinesiology or an exercise science-related field, which indicates that they have had in-class and experiential learning opportunities directly related to their work as an EP. This sets ACSM-EPs apart from certified professionals whose certifications lack such requirements. 

Why

Additionally, the ACSM-EP certification provides a stepping stone for those who have ambitions to become an ACSM Clinical Exercise Physiologist® (ACSM-CEP), which requires clinical experience in addition to a bachelor’s and/or master’s degree. Thus, being an ACSM-EP provides the certificant the opportunity to work with generally healthy individuals in nonclinical settings while gaining the required clinical experience in a supervised setting to become an ACSM-CEP.

How to apply

A qualified ACSM-EP candidate must possess these basic credentials, and master knowledge, skills and abilities within four domains:

Credentials —

1. Bachelor’s degree in an exercise science-related field (or be enrolled in the last semester of the degree program). View course requirements here.

   1. Starting August 15, 2027, candidates will be required to have a bachelor’s degree from an institution that is accredited through the Commission on Accreditation of Allied Health Education Programs (CAAHEP), which will further strengthen the credibility of the certification. Learn more. 

2. Currently CPR/AED certified 

Knowledge, Skills and Abilities —

1. Health and Fitness Assessment 

2. Exercise Prescription and Implementation 

3. Exercise Counseling and Behavior Modification 

4. Risk Management and Professional Responsibilities  

Access detailed exam content outline

Value to employers

Employers can expect ACSM-EPs to be highly knowledgeable in the aforementioned areas, such that they can immediately work with generally healthy individuals, as well as those with medically controlled diseases. An ACSM-EP should be able to successfully conduct proper client assessments, develop and apply evidence-based exercise programs, implement proper behavior-change techniques and minimize the risk of injury for clients and staff. 

Thus, employers should be eager to provide the ACSM-EP with the opportunity to enhance the lives of individuals that they serve and be confident in their ability to lead others through appropriate exercise programs and related tasks.

As a fitness professional, working with a client with intellectual and developmental disabilities (IDD) can present a uniquely difficult, though rewarding, experience. People with IDD face unique barriers to engaging in and adopting regular fitness regimens, including individual physical and cognitive limitations, time constraints and transportation restrictions, and access to facilities and appropriate programming.¹ Therefore, tailoring a fitness intervention to the individual client is of even greater importance in this population. 

Preference Assessment 

It is no secret that it’s easier for people to adopt a regular physical activity routine if they enjoy the activities they’re performing. Administering a preference assessment as part of a client’s pre-participation examination is a great way to find intrinsically motivating factors you can incorporate into their training sessions. A preference assessment is a short battery of questions — such as “What are your favorite upbeat songs?” “What are your favorite animals?” or “What do you like to talk to friends about?” — that tells you about your client’s likes and drives. The assessment should include a lot of open-ended questions so as to capture as many motivating factors as possible. Adapting your training sessions based on the information you collect in this preassessment can go a long way to improving your client’s enjoyment — and, therefore, long-term adoption — of regular exercise.

Practical Example: An ongoing trial in our lab involves VO₂ peak treadmill assessments for adults with Down syndrome (DS)². Along with the difficulty of the actual exercise, the participant also has to wear a lot of equipment during the assessment, including a silicon facemask and breathing valve. After learning about the participants through a preference assessment, we can make the mask and valve more relatable by saying, “This is your superhero mask” or, “You look just like an astronaut” to reduce the anxiety they might experience when wearing it.

Physical Differences

Understanding the physical differences certain conditions cause will improve your clients’ safety. For instance, clients with Down syndrome have increased levels of hypotonia (low muscle tone) and ligamentous laxity, both of which you’ll want to consider when introducing foundational movements and ensuring proper form. Those with other IDD may have an aversion to sound or touch, which is also important to gauge beforehand. Safety is paramount when working with clients with IDD, so administering a comprehensive pre-participation screening that involves an in-depth health history will allow you design a program that’s both safe and effective.

Practical Example: Roughly half of individuals with Down syndrome have congenital heart defects (CHD)³.Although small, exercise inherently increases the risk for heart-rhythm and other heart-related changes. Performing a pre-exercise screening will help identify any CHD so you know what clinical signs to be aware of during the client’s fitness assessments and exercise sessions.

Travel Barriers

It’s important to think outside the box when you’re addressing travel-related barriers to exercise. What can you do when your client can’t get to you? Virtual training visits via videoconferencing software and in-home training are both great ways of increasing your clients’ access to exercise, allowing them to exercise in a familiar environment that reduces distractions and potential sensory aversions. Although their access to equipment may be limited when using these methods, a well-developed fitness program allows for flexibility and adaptation to different environments. Using a combination of facility-based training, virtual visits and in-home training can benefit individuals with IDD by making the program more enjoyable. There are limitations, of course: Virtual training requires access to a device capable of running videoconferencing software, and the fact that you’re not physically present may make ensuring client safety more difficult. And in-home training requires you to travel, adding time and expense.

Practical Example: For several years, our lab has delivered remote group-exercise sessions to adolescents and adults with IDD as part of internally and externally funded trials. These sessions involve a staff member who instructs 4-8 participants via videoconference. These sessions are aimed at improving a particular component of fitness and adapt routine fitness movements to be more relatable. Weekly lesson themes include animal movements, winter sports, hiking, yoga, etc. With the obvious increases to access and reduction in caregiver burden also comes the benefit of an added social component — the interpersonal interaction that occurs participant-to-participant and participant-to-instructor.

Working with clients with IDD presents a unique experience for the fitness professional. It is important to understand barriers to physical activity and ways to mitigate them. Pre-participation health screenings and preference assessments will help you develop a safe, effective and relatable program. After all, the goal of any fitness program is long-term adoption, so implementing a multifaceted, adaptable approach will ensure a good experience for both you and your client.

References: 

1. Must A, Phillips SM, Curtin C, et al. Comparison of sedentary behaviors between children with autism spectrum disorders and typically developing children. Autism 2014; 18(4): 376-384.
2. Ptomey LT , Szabo-Reed AN,Martin LE, et al. The Promotion of Physical Activity for the Prevention of Alzheimer's Disease in Adults with Down Syndrome: Rationale and Design for a 12 Month Randomized Trial. Contemp Clin Trials. 2020. 19(1):100607.
3. Irving, C.A., & Chaudhari, M.P. Cardiovascular abnormalities in Down's syndrome: spectrum, management and survival over 22 years. Arch Dis Child. 2012. 97(4): p. 326–330.

Joseph Sherman, M.S., is a clinical research coordinator with the Division of Physical Activity and Weight Management at the University of Kansas Medical Center who specializes in physical activity modifications and lab-based fitness assessments for special populations, including individuals with intellectual and developmental disabilities.

Cardiovascular disease remains the leading cause of death in women, and hypertension is a major contributing factor, particularly after menopause. The sympathetic nervous system — historically viewed as the “fight or flight” part of our autonomic nervous system — is involved in regulating blood pressure (BP) and can contribute to the development of hypertension. Previous studies have shown that BP increases more in postmenopausal women during exercise compared to younger women. This exaggerated exercise-induced BP response increases cardiovascular risk in postmenopausal women, yet the underlying mechanism(s) remain unknown. Moreover, it is unclear if these exaggerated BP responses are due to aging or if they are related to declines in ovarian hormones like estradiol that are associated with menopause.

In our current study in the March 2022 issue of Medicine & Science in Sports & Exercise_®, we examined the BP response during isometric handgrip exercise. We sought to determine if the large increases in BP during exercise in postmenopausal women are due to changes in the sympathetic nervous system. We directly measured sympathetic nervous system activity using a technique called microneurography. This method allows us to assess how frequently the nervous system is firing at rest and in response to isometric handgrip exercise. This measurement, along with beat-to-beat BP, was compared between young premenopausal women and postmenopausal women. We also tested a separate group of postmenopausal women before and following one month of transdermal estradiol therapy. Our data show that the sympathetic nervous system is overactive and increases to a greater extent during handgrip exercise in postmenopausal women, contributing, in part, to the larger increases in BP. However, these large increases in sympathetic nervous system activity and BP during handgrip exercise were attenuated in postmenopausal women after one month of estradiol therapy. We conclude that both aging and changes in estradiol that occur with menopause contribute to the exaggerated increases in sympathetic nervous system activity and BP during isometric exercise in postmenopausal women.

Since the release of the Women’s Health Initiative data roughly 20 years ago, numerous research studies have demonstrated that hormone therapy can be safely used by the majority of postmenopausal women. Although hormone therapy may not serve as a primary prevention to reduce the development of cardiovascular disease, it has become clear that it does not necessarily carry the risk once thought if used within established guidelines. Our data show that transdermal estradiol therapy can attenuate sympathetic nervous system activity and BP during exercise. However, in terms of primary prevention for cardiovascular disease, it is well established that exercise is a cornerstone therapy for lowering BP and improving cardiovascular health. Our data bring awareness to the importance of monitoring BP in women during physical activity while reinforcing the need to specifically consider BP in exercise-prescription guidelines for women. Notably, recent data suggest that the risk for development of cardiovascular disease begins at a lower BP threshold for women compared to men.

The inclusion of women in research is paramount for improving human health. Our findings demonstrate that studies focused on women remain important to gain a better understanding of cardiovascular disease risk in women. 

Megan M. Wenner, Ph.D., is an associate professor in the Department of Kinesiology and Applied Physiology at the University of Delaware. She received a Ph.D. in physiology from the University of Delaware and completed her postdoctoral training at the John B. Pierce Laboratory and Yale School of Medicine. Dr. Wenner’s research focuses on cardiovascular health in women throughout the lifespan, with a focus on sex hormones and menopause.

Paul J. Fadel, Ph.D., is a professor in the Department of Kinesiology and associate dean for Research at the University of Texas at Arlington. Dr. Fadel’s research focuses on neural cardiovascular control mechanisms in human health and disease, with a specific emphasis on the sympathetic branch of the autonomic nervous system.

Viewpoints presented in SMB commentaries reflect opinions of the authors and do not necessarily represent ACSM positions or policies. Active Voice authors who have received financial or other considerations from a commercial entity associated with their topic must disclose such relationships at the time they accept an invitation to write for SMB.