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  • ACSM's 2024 Key Policy Goals; Legislative Spotlight on PHIT

    by Caitlin Kinser | Jan 16, 2024
    Policy corner January 2024 update

    As we embark on a new year, the American College of Sports Medicine (ACSM) is excited to outline its key policy goals for 2024. These initiatives are crafted with a vision to promote health and wellness, empower communities, and contribute to the overall well-being of individuals across the nation. 

    Promoting Physical Activity as a Public Health Priority 

    • Advocate for increased funding and resources dedicated to public health campaigns that emphasize the importance of regular physical activity. 

    • Collaborate with policymakers to integrate physical activity initiatives into broader public health strategies, aiming to reduce the prevalence of chronic diseases. 

    Addressing Health Disparities Through Inclusive Wellness Programs 

    • Champion policies that encourage the development and implementation of inclusive wellness programs, ensuring accessibility for individuals of all backgrounds and abilities. 

    • Collaborate with community organizations to create targeted initiatives addressing health disparities, with a focus on underrepresented populations. 

    Enhancing Physical Education in Schools 

    • Advocate for comprehensive, evidence-based physical education curricula that prioritize long-term health and fitness. 

    • Work with education stakeholders to ensure that schools have the necessary resources and support to provide high-quality physical education to all students. 

    Supporting Research and Innovation in Exercise Science 

    • Promote policies that allocate resources to advance research in exercise science, with a focus on discovering innovative approaches to improve physical and mental health. 

    • Advocate for increased funding for research grants, fostering collaboration between academia, industry, and healthcare professionals. 

    Fostering Healthy Work Environments 

    • Collaborate with businesses and policymakers to encourage the implementation of workplace wellness programs, promoting physical activity and mental well-being among employees. 

    • Advocate for policies that incentivize companies to create environments conducive to a healthy and active lifestyle. 

    Ensuring Access to Exercise Professionals’ Expertise 

    • Advocate for policies that support increased access to exercise professionals, ensuring that individuals of all ages have timely and affordable access to expert care. 

    • Collaborate with healthcare organizations to develop strategies for integrating exercise professionals’ expertise into primary care settings. 

    ACSM is committed to working diligently on these policy goals throughout 2024, with the belief that these initiatives will contribute significantly to building a healthier and more active nation. The college looks forward to the support and collaboration of its members and certified professionals as we strive to make lasting, positive impacts on the health and well-being of individuals across the United States.

     

     

    Legislative Spotlight 

     

    PHIT Act 

    In 2018, the Personal Health Investment Today (PHIT) Act passed the House of Representatives for the first time, but Congress adjourned before the Senate could vote. On March 14, 2023, Representative Mike Kelly [R-PA] and Senator John Thune [R-SD] reintroduced PHIT in the House (H.R. 1582) and Senate (S. 786). Currently, there are 61 cosponsors in the House of Representatives and 16 cosponsors in the Senate. 

    PHIT will allow flexible spending accounts (FSAs) and health savings accounts (HSAs) to pay for health club memberships, fitness equipment, exercise videos, and youth sports leagues. If passed, PHIT would enable individuals to use up to $1,000 per year—up to $2,000 for families—to cover physical activity-related expenses. 

    4 Reasons to Support the PHIT Act 

    1. SAVINGS: PHIT could help Americans save 20-30% on yearly expenses related to physical activity. By increasing physical activity, reducing smoking and obesity, and improving treatment rates, $116 billion could be saved yearly. 

    1. PREVENT & REDUCE CHRONIC DISEASES: Physical activity is a cost-effective way to prevent and reduce chronic diseases, which account for approximately 86% of nationwide healthcare costs. 

    1. HELP KIDS SUCCEED: Children and adolescents who exercise regularly experience less anxiety and stress, have healthier bones and muscles, develop higher self-esteem, and are less likely to be obese—which could save them up to $19,000 in lifetime medical costs. 

    1. THINK BETTER, FEEL BETTER: Physical activity can help prevent depression, and can be an effective treatment comparable to pharmacotherapy or psychotherapy. It can also help improve cognitive ability and reduce the risk of dementia. 

    The PHIT Act will play an important role in getting more Americans up and active by lowering the cost of physical activity through tax incentives. PHIT continues to gain bipartisan support in both the House and Senate. For more information on H.R. 1582, please click here.  For more information on S. 786, please click here. 

  • Active Voice | How to Prescribe Exercise for Brain Health

    by Greg Margason | Jan 10, 2024
    How to Prescribe Exercise for Brain Health

    Alzheimer’s disease and related dementias are among the world’s foremost health and economic challenges, impacting over 55 million people worldwide and costing more than 1.3 trillion U.S. dollars in 2019 alone. With no imminent cure, there is an urgent need for interventions that reduce dementia risk in healthy older adults. 

    Physical exercise is one of the greatest modifiable risk factors for dementia. Yet, exercise prescriptions for brain health in older adults are lacking. Unfortunately, the consequences of this are twofold. First, people may undervalue the clinical utility of exercise for dementia prevention, and second, it poses a barrier to the recommendation of exercise for healthy aging in primary care settings. Our graphical review, published in Exercise, Sport, and Movement, attempts to remedy this by providing evidence-based exercise prescription principles for dementia prevention as a starting point to help guide clinical practice and research. 

    Building on current scientific evidence, we reviewed the state of knowledge concerning brain-level changes that occur with aging. We included details on why memory is impacted in healthy aging and how these changes progress toward dementia. To help readers understand how exercise promotes the brain’s health, we described pertinent physiological mechanisms through which exercise impacts the brain to support memory. Ultimately, we synthesized this fundamental knowledge into practical exercise prescription principles to help individuals and practitioners formulate evidence-informed exercise programs to support brain health. 

    A notable strength was our use of the FITT framework — which details the frequency, intensity, time and type of exercise — thus providing the necessary components for formulating effective exercise prescriptions. We highlighted the similarities and differences in the suggested exercises for brain health versus those recommended by ACSM for cardiorespiratory, musculoskeletal and neuromotor fitness. Respecting the reality that one size does not fit all, we offer a flexible formula for creating exercise prescriptions that can be adapted to fit everyone’s unique needs. 

    That said, the evidence suggests that certain types and intensities of exercise should be incorporated into every exercise prescription for brain health. Specifically, exercise “type” should include aerobic (walking, cycling, swimming, etc.), resistance (free weights, resistance bands, yoga, Tai Chi, etc.) or a blend of both types of exercise. Exercise “intensity” should include moderate to vigorous activities relative to the individual’s baseline cardiorespiratory fitness capabilities. In contrast, exercise “frequency” and “time” (duration) permit more freedom. Instead of setting a rigid threshold, the emphasis is on some physical activity is better than no physical activity (i.e., being sedentary), with the understanding that brain health is best supported by consistent engagement in regular exercise. 

    As a starting point, we encourage practitioners to download the final figure of our graphical review, Figure 4, to initiate conversations about exercise with their clients. Practitioners are also encouraged to use behavioral change techniques like brief action planning and SMART goal setting to help their clients create and commit to an exercise plan that is feasible for them. For practitioners with limited experience with exercise prescription, a referral to an ACSM Certified Clinical Exercise Physiologist® can ensure each patient receives the appropriate guidance. 

    With the growing aging population and the rising prevalence of dementia, it has never been more important to optimize exercise programming for better brain health. We hope these principles for prescribing exercise for brain health will help stave off cognitive decline one step at a time. 

    Jennifer Heisz
    Jennifer Heisz, Ph.D.,     is an associate professor in kinesiology at McMaster University, director of the NeuroFit lab, and author of Move the Body, Heal the Mind. She is the interim editor-in-chief for ACSM’s premier open-access journal, Exercise, Sport, and Movement. Her research examines how physical activity promotes brain function, mental health and cognition in young adults, older adults and individuals with Alzheimer’s disease. 


    Emma Waddington

    Emma Waddington, M.Sc.,     is a McMaster University alumna and member of the NeuroFit lab. Her work examines the impact of orienteering training on cognitive function and has been featured in The New York Times, NBC and others. 


    Viewpoints presented in ACSM Bulletin commentaries reflect opinions of the authors and do not necessarily represent positions or policies of ACSM. 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 the ACSM Bulletin. 

  • Clinical Highlights from Current Sports Medicine Reports

    by Caitlin Kinser | Jan 09, 2024

    Quarterly Editor's Picks, CSMR journal cover and headshot of editor Dr. Shawn KaneOne of the best parts of Current Sports Medicine Reports (CSMR) are the interesting and educational case reports that are submitted. They are informative and highlight interesting clinical cases that help to increase our knowledge base and remind us to maintain a high degree of clinical suspicion and to keep searching for answers when things just don’t add up like they should.

    I would like to highlight three not-to-be-missed cases from the past quarter:

    Blunt Ocular Trauma in Sport submitted by Daniel, et al. is an interesting (and must say scary) case of traumatic vision loss while playing soccer. Player sustained trauma to the eye from a kicked ball and had 30 minutes of monocular blindness prior to seeking medical care. The player was appropriately diagnosed and treated for traumatic iritis and commotio retinae and was able to return to play with complete resolution of symptoms. The authors of this interesting case report go on to discuss what is needed for a timely and thorough sideline assessment as well as the differential diagnosis for ocular trauma. 

    Popping Pimples or Bones? A Clinical Vignette of a Lacrosse Player on Isotretinoin with Multifocal Lower-Extremity Bone Stress Injuries submitted by D’Amico and Schroeder. This case to me highlights the importance of taking a good history, doing a thorough medication reconciliation, and searching for answers when things do not add up. I am sure many of us have a lot of patients taking isotretinoin for acne and if they have a bone stress injury would you think about stopping the use of isotretinoin? 

    Platelet-rich Plasma (PRP) Treatment of a Quadriceps Tendon Tear in a Collegiate Basketball Athlete submitted by Lutz, et al. is an interesting case using PRP to treat a quadriceps tear. Extrapolating data from the treatment of patellar tendon injuries the authors used PRP as well as traditional rehabilitation to treat the injury and return to athlete to sport. One highlight that is important for this case is the authors thoroughly and objectively describe the components of their PRP injection and rehabilitation program, so that others can replicate it. 

    We also have awesome articles that cover a variety of areas, and I would like to highlight three from the past quarter:

    Assessment of the Current State of Sports Coverage Participation, Training, and Confidence Ratings among PMR Residents and Residency Programs submitted by Stokes, et al. This is an article in our Clinical Curriculum Series, and it shows that exposure to sports medicine during training leads to confidence. While completed with PMR residencies, I am pretty sure this would be similar amongst all Sports Medicine disciplines.  Hopefully, this information can help other programs dedicate time to sports medicine interests. 

    Clinical Considerations in Returning Pediatric and Young Adults with Cancer to Physical Activity submitted by Dykowski, et al. We know that physical activity is beneficial and can be an adjunct treatment for many conditions. When and how to get patients with cancer diagnoses back to physical activity can be challenging due multiple variables. The authors of this paper do to an excellent job at providing some guidance on clinical considerations when contemplating a return to activity. As we continue to improve cancer treatments, getting patients exercising will be good for their physical and mental health. 

    Lastly, as we continue to address the conditions of pediatric obesity and inactivity, I would like to highlight the article May the Force Be with Youth: Foundational Strength for Lifelong Development submitted by Faigenbaum, et al. I would suggest that every Primary Care Sports Medicine provider read this and share it with their Primary Care Colleagues.  This article provides excellent information on not only the why this concept is important but also provides some excellent information on how to address it. This is crucial for the long-term health, wellness, and safety of our nation. 

    CSMR is ACSM’s official monthly clinical-review e-journal. Written specifically for physician and clinician members, CSMR articles provide thorough overviews of the most current sports medicine literature. ACSM physician members receive an online subscription to this journal as a member benefit.

    Shawn Kane headshot 2024Shawn F. Kane, MD, FACSM is a family physician, associate professor in the Department of Family Medicine, and adjunct assistant professor in the Department of Exercise and Sports Science at the University of North Carolina (UNC) Chapel Hill. He received his medical degree from the Uniformed Services University of the Health Sciences and served in the U.S. Army for 27 years. While in the Army he spent more than 18 years serving as a physician-leader in numerous units within the US Army Special Operations Command. He is interested in sports medicine, concussion care, veterans’ health, and primary care of patients with post-traumatic stress disorder. Dr. Kane joined ACSM in 2003 and became a fellow in 2011. He currently serves as the editor-in-chief for     Current Sports Medicine Reports, on ACSM’s Clinical Sports Medicine Leadership Committee, ACSM’s Health & Fitness Summit Program Committee, and ACSM’s Program Committee. Outside of the office, Dr. Kane enjoys hanging out with his Leonbergers (big furry, cute German Mountain dogs), as well as working out and traveling.

  • Top News Articles of 2023

    by Caitlin Kinser | Dec 19, 2023
    top news stories 2023 with various designs in dark and light blue, yellow and withThousands of news articles and media stories are published/aired every year that cite ACSM subject matter experts and publications. These are the five articles with the widest reach published in 2023.

    ACSM gets a GREAT shoutout from Al Roker on The Today Show and another story on NBC’s Nightly News (NBC News)

    "If you're sitting all day, science shows how to undo the health risks. Take 'activity snacks' every 30 minutes."

    During the segment, a study published in the journal of the American College of Sports Medicine cites researchers at Columbia University who say that there are health benefits to walking for five minutes every half hour.


    MSN.com     and USA Today cover the announcement of America's Fittest Cities

    "What is the fittest city in America? The answer has a lot to do with sleep and mental health"

    This story delivered a huge potential reach of 514M and included several mentions of ACSM along with a quote from ACSM’s American Fitness Index spokesperson Stella Volpe.

    "We need people to be more physically active," said Stella Volpe, chair of the American Fitness Index Advisory Board and ACSM president-elect. "It doesn't have to be running a marathon. It could be out for a walk with your friends, your dogs, your family."


    NPR: Morning Edition     and CNN cover an article published in MSSE

    "Sitting all day can be deadly. 5-minute walks can offset harms" | NPR

    "Sitting too much is bad for your health, but offsetting the impact is easy, study shows" | CNN

    In both stories, researcher and ACSM member Keith Diaz of Columbia University Medical Center describes how he and his colleagues set out to find out what's the least amount of physical activity a person must do to offset the health risks of sitting. They recruited volunteers to come to their lab and emulate a typical work day. The NPR story also sources ACSM member Dr. Robert Sallis.

    Media seek the expertise of ACSM members following the on-field collapse of NFL athlete Damar Hamlin

    "After Damar Hamlin's cardiac arrest, attention turns to chest pads for young athletes" | NBC News

    "What to Know About Damar Hamlin's Heart Event, Commotio Cordis" | TIME

    In both stories, ACSM Chief Medical Officer Dr. Bill Roberts is sourced. '"If we're looking at the risk reduction of adding a chest plate, compared to the risk reduction of training everybody in hands-only CPR having an AED available at sites, it would fall heavily on CPR and AEDs in terms of lives saved,' said Roberts, who is affiliated with the American College of Sports Medicine."

    Indianapolis, ranked 97th out of 100 in the American Fitness Index, receives multi-million dollar grant to improve local parks

    "Indy Parks to get $80M in grants from Lilly Endowment" - The planned projects will take place through 2025. | WTHR Channel 13 (NBC, Indianapolis)

    "This investment is massive in terms of infrastructure within parks,” said Gretchen Patch, American College of Sports Medicine senior director of strategic health initiatives and partnerships. “But it has to be complemented by long-term programming and engagement with those community partners. You can't just throw money at a problem and fix it, but it can get things started." 

  • Why Checking the Box to Exercise isn’t Sufficient for Your Health

    by Greg Margason | Dec 19, 2023
    Why Checking the Box to Exercise isn’t Sufficient for Your Health

    Scenario: The sound of an alarm wakes you up at 6:30 a.m. to start your day. Upon waking up, you decide to go for a jog at the local park, but you are restricted to 30 minutes because of a work meeting scheduled for 8:30 at the office. After exercising, you sit down to pour your favorite cereal and eat breakfast, before driving to work for 20 minutes. You arrive in time for your meeting, which lasts longer than expected, ending around 10. Once the meeting is over, you return to your office to catch up on emails and tasks before going to lunch meeting with a few co-workers. While at lunch, you and your co-workers share personal stories and work-related updates for about an hour before returning to the office to finish up tasks and additional meetings prior to leaving work at 4:30 p.m. After leaving work, you drive back home to cook dinner leftovers before watching television until bedtime around 10 p.m. A similar but different routine repeats the following day - but why is this important even though you exercised?! 

    The 24-hour day entails four distinct behaviors called the 24-hour activity cycle. These behaviors are sleep, sedentary behavior, light physical activity, and moderate to vigorous physical activity. Current physical activity guidelines recommend that adults engage in at least 150 minutes per week of moderate physical activity, at least 75 minutes per week of vigorous physical activity or some combination of both. Sedentary behavior recommendations suggest adults “sit less and move more” due to a paucity of evidence during the development of the 2018 Physical Activity Guidelines for Americans. Finally, the National Sleep Foundation recommends that adults sleep at least seven hours a day. Thus, accurately measuring all these behaviors and meeting their recommendations pose a challenge. 

    All of behaviors of the 24-hour activity cycle are individually and independently associated with health. Ample evidence suggests that more time spent in moderate to vigorous physical activity and less time in sedentary behavior reduces the risk of a wide range of negative health outcomes such as hypertension, diabetes, cancer, cardiovascular disease, stroke, and a shorter mortality. By contrast, more time spent in sedentary behavior and less time in moderate to vigorous physical activity increases the risk of these negative health outcomes. Finally, current evidence also suggests a short sleep duration (less than seven hours per day) also poses similar negative health consequences as sedentary behavior. As such, growing evidence has now suggested that the combined effects of all these behaviors may be greater than their individual effects.  

    Time spent in one of these complex behaviors will offset time spent in the remaining behaviors. Meeting the aerobic physical activity recommendations or exercising for an hour each day, constitutes only about two percent of a 24-hour day. The remaining 98% of our day and behaviors (sleep, sedentary behavior and light physical activity) should be considered. Meta-analytical evidence suggests even if an individual meets the aerobic physical activity recommendations and engages in high levels of sedentary time throughout the day, the risk of mortality remains high. Previous research has also shown that even physical activity-focused programs do not yield meaningful reductions in sedentary time as an individual can be physically active (e.g. exercise 30 min/day) and yet spend the rest of the day sedentary. Thus, focusing efforts on a single behavior limits efficacy and may lead to spurious conclusions for our health. 

    To help inform a paradigm shift in this area future progress should be established in different areas. Research investigation should consider examining efforts to determine appropriate levels of sleep, sedentary behavior, light physical activity, and moderate to vigorous physical activity (or in certain combinations) to establish optimal 24-hour day recommendations. The fitness and medical community may also benefit in this area by exploring innovative tactics to understand time spent beyond their client’s exercise session to design a healthy 24-hour day.  

    More information about the 24-hour activity cycle can be found in three distinct continuing education courses. 

    Benjamin BoudreauxBenjamin D. Boudreaux, Ph.D. is a postdoctoral fellow at Columbia University Irving Medical Center. His research area of emphasis lies at the intersection of exercise science and physical activity epidemiology. His primary research interests includes examining the relationship between the 24-Hour Activity Cycle in the prevention or treatment of cardiovascular disease and other human health outcomes. He has extensive experience with consumer wearable devices in different populations for validation purposes or as a tool to alter physical activity and sedentary behaviors. Beyond research, Dr. Boudreaux devotes his service efforts towards the disability and Type 1 Diabetes communities such as running the 2023 TCS NYC Marathon for Type 1 Diabetes awareness and presenting or publishing about the importance of physical activity and exercise in the autism community.


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