Clinical Exercise Physiology is a sub-discipline of Exercise Physiology that focuses on cardiovascular, pulmonary, and metabolic diseases. Clinical Exercise Physiologists usually work under the supervision of a physician in a hospital or clinic-based setting and are part of a larger health care team. This larger team can include physical therapists, occupational therapists, physicians, nutritionists, psychologists, social workers, and nurses. All staff should be trained in CPR and Advanced Cardiac Life Support (ACLS). Emergency equipment (defibrillators) should be on hand and a full emergency plan should be in place, especially if the facility is not within a hospital facility
The main employment opportunity for a Clinical Exercise Physiologist is a Cardiac Rehabilitation program. This is a medically supervised hospital-based program for patients who have had a myocardial infarction (heart attack), coronary artery bypass graft (CABG) surgery, Percutaneous transluminal coronary angioplasty (PTCA) (stent placed in a coronary artery), or those with current stable angina pectoris (chest pain), heart failure, and those waiting for or following heart transplant surgery. The overarching goal of Cardiac Rehabilitation is to improve a patient’s overall outcome and quality of life. To do so, the staff must focus on three areas, including the patient’s physical well being (including their level of physical activity), their psychological well being, and their social interactions with those around them.
- Inpatient - Inpatient or in-hospital Cardiac Rehabilitation begins almost immediately after a cardiac event (heart attack) or procedure (heart bypass surgery). The initial activities the Clinical Exercise Physiologist will be assisting with at this time include helping the patient sit and stand without assistance, while working up to walking independently, which will help move them toward discharge from the hospital. Additionally, a home walking program can be discussed prior to discharge and preparation for the patient to begin outpatient Cardiac Rehabilitation can be addressed.
- Outpatient - Outpatient Cardiac Rehabilitation programs may be found within a hospital, in a hospital-associated clinic, or even as part of a fitness facility. Patients can begin as early as one to two weeks after discharge. The goal of any outpatient program should be to assist the patient in completing a safe and effective exercise and lifestyle modification program. This should help the patient return to work, resume their recreational activities, and those activities of daily living that might be difficult right after their cardiac event or procedure. Supervision and monitoring are key during this time to make sure that there are no additional cardiac problems that might limit their progress. Clear communication between the staff and the medical team is important to identify and then treat any complications before they become serious. Education is vital to help the patient and their family understand how to modify their cardiovascular disease risk factors to better treat the underlying cardiovascular disease.
Heather Hayes, M.A.
ACSM Midwest Chapter
Clinical Exercise Physiology: What Is It? Where Would I Work?