Posted by Victoria Sanderson
Exercise physiology is a relatively new service at HammondCare Greenwich Hospital. Here we profile what it is and how patients can expect to benefit from it.
Exercise physiology is the use of exercise to treat a wide range of illnesses and conditions. Exercise physiologists (EPs) can prescribe exercise and develop programs to treat and manage specific health conditions such as diabetes, cardiovascular disease, osteoporosis, cancer, arthritis and more.
Exercise that’s individually tailored
Exercise physiology programs are highly tailored; they’re designed to meet your own goals based on your lifestyle and level of function.
For instance, if you want to be able to walk for 20 minutes to go to the shops, or lift up small children, or even play golf on the weekends, your EP will find the safest and most beneficial form of exercise for you.
Likewise, if your goal is to reduce chronic pain, prevent a chronic illness or manage other symptoms, your EP can provide exercise and lifestyle therapies to help.
Your EP will take into account your regular exercise habits, strength and fitness levels, all related medical conditions, and any medications you may be taking when working with you. It is not a one-size-fits-all approach; your EP will find the most appropriate and enjoyable forms of exercise for your individual needs and preferences.
"The difference that exercise physiology makes to a person’s life is really significant. Seeing the joy on someone’s face when they are able to put their own shoes on again; that’s very satisfying."
- Natalie Delana, Exercise Physiologist,HammondCare Greenwich Hospital
When you are managing a chronic condition, or not feeling at your best, the thought of exercise can be a bit daunting. But Natalie Delana, Exercise Physiologist at HammondCare Greenwich Hospital, says that it’s important to remember that exercise prescribed by a health professional in consultation with your other physicians, is very safe and can be beneficial. Exercise can have physical benefits such as improved muscle strength and endurance, improve bone density, lower blood pressure, lower cholesterol, lower blood glucose and improve cardiovascular fitness and energy but it also has psychological benefits such as alleviating depression symptoms, reducing stress and anxiety and improving quality of life.
Who should see an EP?
Because the prescription of exercise has benefits for such a broad range of health conditions, nearly anyone can benefit from working with an EP. Anyone with chronic pain or other health conditions, or anyone at risk of a health condition (such as someone with pre-diabetes or with a family history of cardiovascular disease) might like to see an EP about how an exercise routine can help prevent, manage or treat their symptoms.
Natalie Delana also says that exercise physiology can be of particular help for people with mental illnesses and conditions such as depression. Because EPs receive a broad medical training, they are skilled in understanding how physical exercise interacts with physiological and psychological conditions.
You can see an EP with or without a referral from your GP.
What if I’ve never done much exercise before?
You don’t need to be a regular exerciser to see the benefits of exercise but seeing an EP to get you started on the right track is important. Your EP will tailor your program to your individual needs, tastes and preferences, they will take your exercise history into account and ensure your program is at an appropriate starting level.
EPs will also work with you to integrate exercise programs into your everyday activities and lifestyle. While your exercise physiologist can give you your program and work with you on a regular basis, it is likely they will expect you to do some work on your own or at home. They will help you find the easiest, most enjoyable ways to do this.
What is the difference between exercise physiology and personal training?
EPs complete a minimum of four years of university training, compared to personal trainers’ 6 to 18 months training. EPs are recognised professionals in the allied health sector, and trained to prescribe exercise for specific clinical conditions. Personal trainers generally work with people who are already healthy, and do not prescribe exercise for the relief or management of medical symptoms.
Where can I see an EP?
In late 2014, David* came into HammondCare Greenwich Hospital for rehabilitation after a total hip replacement. Prior to this David had been very active, especially for an 85-year old – he cares for his wife full-time, and played golf at a competitive level. Understandably, he hoped to return to this lifestyle after the hip replacement surgery.
However, returning to such a high level of function after a serious surgery is quite risky. The staff at Greenwich needed to prepare his body as holistically as possible for the transition back into caring for his wife and being back on the golf course.
David saw both the physio team and Natalie Delana, the Exercise Physiologist at Greenwich. The physio team worked with him on his hip, to improve his mobility, leg strength and gait. Natalie focussed on functional exercises such as manual handling techniques, to improve David’s strength in lifting and turning while caring for his wife. As he was keen to get back into his golf, Natalie also emphasised bending, lifting and general fitness exercises. The Physio and Exercise Physiologist worked in collaboration to ensure all parts of David’ rehabilitation was considered and his treatment was maximised.
After an eight-week program, David’s improvements were impressive. In a standard quality of life questionnaire, the team found that David’s physical function improved by 15%, his emotional wellbeing improved by 12% and his energy level by5%. A submaximal fitness test on the treadmill showed at 35% improvement in cardiovascular fitness. His pulling strength previously at 9kgs, was now 20kgs, and his lift and carry abilities improved from 5kgs to 12 kgs.
As Natalie says, “Really amazing results of strength and fitness for anyone let alone an 85 year old!” The Physio team reported significant improvement in David’ mobility, gait, leg strength and function, he improved by up to 4 seconds on his movement assessments and progressed to not requiring a walking stick for mobility.
But the best news, of course, is that David was able to get back to golf, and plans to bring his wife along to see Natalie at Greenwich. They both intend to continue to attend the Greenwich Fitness Gym twice a week, to maintain their function and fitness.
*Client’s name has been changed.