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Exercise Professionals with Advanced Clinical Training Should be Afforded Greater Responsibility in Pre-Participation Exercise Screening: A New Collaborative Model between Exercise Professionals and Physicians

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Maiorana, AJ, Williams, AD ORCID: 0000-0001-8863-3491, Askew, CD, Levinger, I, Coombes, J, Vicenzino, B, Davison, K, Smart, NA and Selig, SE 2018 , 'Exercise Professionals with Advanced Clinical Training Should be Afforded Greater Responsibility in Pre-Participation Exercise Screening: A New Collaborative Model between Exercise Professionals and Physicians' , Sports medicine , pp. 1-10 , doi: 10.1007/s40279-018-0888-2.

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Abstract

Regular exercise improves health but can alsoinduce adverse responses. Although such episodes are rare,many guidelines for pre-participation exercise screeninghave historically had a low threshold for recommendingmedical clearance prior to the commencement of exercise,placing the responsibility for decision making about exerciseparticipation on physicians. The ‘clearance to exercise’model still occurs widely in practice, but creates costburdens and barriers to the uptake of exercise. Moreover,many physicians are not provided the training, nor time in astandard consultation, to be able to effectively perform thisrole. We present a model for pre-participation exercisescreening and the initial assessment of clients wishing tocommence an exercise programme. It is designed to guideprofessional practice for the referral, assessment andprescription of exercise for people across the health spectrum,from individuals who are apparently healthy, throughto clients with pre-existing or occult chronic conditions.The model removes the request that physicians provide a‘clearance’ for patients to engage in exercise programmes.Instead the role of physicians is identified as providingrelevant clinical guidance to suitably qualified exerciseprofessionals to allow them to use their knowledge, skillsand expertise in exercise prescription to assess and manageany risks related to the prescription and delivery ofappropriate exercise programmes. It is anticipated thatremoving unjustified barriers to exercise participation, suchas mandated medical review, will improve the uptake ofexercise by the unacceptably high proportion of the populationwho do not undertake sufficient physical activityfor health benefit.

Item Type: Article
Authors/Creators:Maiorana, AJ and Williams, AD and Askew, CD and Levinger, I and Coombes, J and Vicenzino, B and Davison, K and Smart, NA and Selig, SE
Keywords: pre-exercise screening, barriers to exercise
Journal or Publication Title: Sports medicine
Publisher: Adis International Ltd
ISSN: 0112-1642
DOI / ID Number: 10.1007/s40279-018-0888-2
Copyright Information:

Copyright 2018 The Authors. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0) https://creativecommons.org/licenses/by/4.0/

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