ASEPNewsletter
Vol 3 No 4
April 1999
ISSN 1097-9743 
The
ASEPNewsletter is devoted to informative articles and news items about exercise physiology. It is a monthly magazine of news, opinions, exercise physiology professionals, and events that shape exercise physiology. While it contains views and opinions of the Editor who oversees the ASEP Internet Websites, visitors can have a voice as well. We welcome interested practitioners, researchers, and academicians to e-mail the Publisher their thoughts and ideas or to respond directly via the ASEP Public Forum.
Copyright ©1999 American Society of Exercise Physiologists. All Rights Reserved. 
May 1999

Table of Contents

 
ASEP Public Forum
comments by Kelly O'Reilly
Just Thinking
by Tommy  Boone
PEPonline
"2" new articles
2nd Annual Meeting Members!
254
Professionalism
and Standards
Guest Editorials
"3"
President's Report
by Robert Robergs
Student Chapters
 JEPonline
"4" new research articles
Dr. Robert Robergs
email YOUR President
Web Sites
of Interest
Congratulations ASEP!
The American Society of Exercise Physiologists has been chosen as HMS Beagle's "Web Pick of the Day." The ASEP web site is featured on their web page.  Our site will then be listed on Beagle's "Favorite Web Sites" page for 30 days.  Later, it will be permanently catalogued in BioMedNetLink; their comprehensive, evaluated database of biological and medical websites. HMS Beagle is a biweekly webzine for biological and medical researchers, with a daily digest of the highest-quality Web resources and published material.  HMS was recently selected as one of Yahoo's top 32 "incredibly useful" Web sites, and has more than 100,000 visits to every issue.  At least a 1000 readers check their daily updates each day. 

Just Thinking
Tommy Boone, PhD, MPH, FASEP

As we look to the new millennium, what will become of the jobs in exercise physiology?  Will the marketplace improve with new physiological measurement tools, new data analysis techniques, and new ways of communicating what we do?  Or, will our professionals need new training and new skills to meet the challenges of the future?  These are not ridiculous questions, and each one needs an answer.  To make sure the profession is ready, ASEP is committed to professional development, certification, and education of exercise physiology professionals.

       ASEP is also aware of the challenge before it by professionals from other healthcare professions.  Take physical therapy, for example, "What are the changes under consideration by its leaders that stand to impact exercise physiology?  Where are they headed, and how do they plan to get there?  Some insight into these questions can be gained the 29th Mary McMillan Lecture by Sahrmann (1998), who is a distinguished leader in physical therapy for more than 30 years.  The lecture covered a lot of material, but one item in particular is critical to physical therapy's vision of the future and it influence on their identity and practice.  According to Sharmann (1998), physical therapy must "continue to develop the concept of movement as a physiological system."

      Why is this point important?  First, what do we know? To begin with, the core of physical therapy's professional identity is "movement" (American Physical Therapy Association, 1995).  What now appears to be important is the notion that they shouldn't limit movement to "...impaired by a lesion in a specific anatomical system."  Second, since medical specialties are based on body systems (Kendall, 1980), physial therapy professonals are eager to establish themselves as experts with movement recognized as a physiological system.

       This is important because it is physical therapy's opportunity to become established, just as exercise physiologists have done with expertise in their knowledge of the physiology of human movement.  Physical therapists are suggesting that they should "...consider all of the systems contributing to movement" (Sahrmann,1998), including the cardiopulmonary and metabolic systems.  Hence, if physical therapy is the movement expert in the healthcare setting, what will be the influence on exercise physiology if it also becomes the exercise expert?

      Is there any liklihood that physical therapists can graduate with the same level of knowledge and skill as exercise physiology graduates?  Today, more than ever before, exercise physiologists are teaching in physical therapy departments.  More precisely, they are teaching exercise physiology, cardiopulmonary rehabilitation, and research courses to physical therapy students.  They are helping physical therapists use and expand their scientific foundation.

      This article points out several small changes in physical therapy.  Perhaps, one important fact we can learn from them is that expertise and responsibility can not be taken for granted.  Whether we like what they are doing or not, we will need to consider what we should be doing that is consistent with our professional and ethical practice of exercise physiology.  To do our role well, we must consider not only how we might profit in the public sector but also the outcome of our actions on our graduates. 



Address comments to: Tommy Boone, PhD, MPH, FASEP


References
1. Kendall, F.P. Fifteenth Mary McMillan Lecture: This I believe. Phys Ther. 1980;60:1437-1443.
2. Philosophical statement on physical therapy (HOD 06-83-03-05). In: Applicable House of Delegates Policies. Alexandria, VA: American Physical Therapy Association; 1995:33.
3. Sahrmann, S.A. Twenty-Ninth Mary McMillan Lecture: Moving precisely? Or takethe path of least resistance? www.apta.org/pt_journal/Nov98/sahrmann.

President's Report
Dr. Robert Robergs has just recently submitted his  "President's Report." To read the complete report, click on March, 1999.

Student Chapters
Letters were mailed from the National Office to ASEP members encouraging them to develop an official ASEP Student Chapters, which reminds me that the Student Chapter at the University of New Mexico is online.   If you are interested in starting a chapter, contact either Dr. Robergs or the ASEP National Office (218-723-6297).

JEPonline
Be sure to click on the April 1999 JEPonline issue of ASEP's exercise physiology journal. There are several research articles for your enjoyment.

More ASEP members....
That's correct! We are an organization of 254 members and still climbing.  To become a member, print the Membership Application and forward it to the ASEP National Office, or call an ASEP representative at (218) 723-6297, or visit additional web sites for more information via the Table of Contents.  Just for fun:Current weather at ASEP National Office

Guest editorials
The Physical Therapy Mindset!
by Lance Tarr

Occupational Medicine and Exercise Physiologists
by Chris Johnson

Can ASEP Make a Difference?
by Dr. Mannie Hall



The ASEPNewsletter is seeking guest editorials -- brief commentaries on a wide variety of issues. Everyone involved in: health, fitness, rehabilitation, and sports, including medical, business, management, psychology, teachers, and students -- is welcome to share insights, concerns, points and counterpoints on any issue that impinges upon the exercise physiology profession.

To contribute a guest editorial, send, FAX (218)723-6472), or e-mail (tboone2@css.edu) an essay and a brief biography. Send your contribution to ASEP National Office, College of St. Scholastica, Department of Exercise Physiology, 1200 Kenwood Ave., Duluth, MN 55811.


The Physical Therapy Mindset!
Lance Tarr, MS, CSCS
ASEP member

I wish to draw to your attention the American Physical Therapy Association's (APTA) mindset at present concerning exercise physiologists (among other disciplines seeking recognition). Below I list verbatim that which appeared in the West Virginia Physical Therapy Association (WVPTA) Bulletin Vol. 40, NO.1 March 1999 Spring Issue in an article written by Michael LaMothe, PT, President, WVPTA:

 "While at Combined Sections Meeting in Seattle in early February I was made aware of potential state issues that are coming up. For example, the ACSM is mounting a campaign to develop a certification exam for anyone with a Masters in Exercise Physiology to become a Clinical Exercise Physiologist. The general interpretation of this is that they wre looking to be reecognized as a specialist with teh ability to treat/rehab any person with any disorder or disease process i.e. a Physical Therapist. They are looking at this as a means to expedite licensure at teh State level in the future. This is already becoming a reality as there is licensure recognition of Ex. Phy. in Louisiana as of the last year. APTA is starting to make Take Action Packets that will be available for chapters and individuals to use in a variety of situations. These packets are already being sent out. The first one is available on ATC's and many more are coming (Kinesiotherapists, Ex. Phys., etc.). These packets will give more information on skills and backgrounds of these various degrees. I will have a copy of teh first Take Action Packet at teh March Meeting in Sutton if anyone woould like to have a look at one." 

I note the ASEP's attempt at outreach to our brethren professional organizations and suggest we do not neglect exchange with the APTA. I, for my part, continue on our ASEP Accreditation and Licensure Committees. In addition, as a committee member of our state association, the West Virginia Association of Exercise Physiologists, I continue my attempt to bring our organization under the guidance of the ASEP as I strongly feel unity from the national level is the best course of action.

As I am closely involved in a PT arena by way employment over the past 10 years, a committee member of our state's professional association involved  in by-laws, scope of practice, and licensure submissions to our state legislature over the past two years, and believe in the ASEP mission, I offer my services in this state in whatever capacity you may feel I can serve. 


Thank you Lance.  What do you think?  Any ideas! 

Occupational Medicine
and Exercise Physiologists
Chris Johnson, MSS, CEP, CLC

I just visited the ASEP website for the first time.  It has caused me to think about something that ASEP members may be able to incorporate into the ASEP exercise physiology scope of practice.

Although I am a licensed clinical exercise physiologist in Louisiana, I do not have the typical exercise physiologist background of education nor do I practice as a typical exercise physiologist.  I attended the the University of Southwestern Louisiana and did not know what I wanted to do until 3 years into college, at which time I promptly went into General Studies to facilitate graduation.  As you realize, many schools do not have Exercise Physiology as a major.  Following graduation, I got my master's degree from the US Sports Academy in Fitness Management.

My professional work deals with Occupational Medicine.  I have a lot of experience performing the following testing and rehabilitation concerns:

  • Functional capacity evaluations (testing of injured workers to determine work level)
  • Ergonomic/job analysis
  • Pre-placement screenings (testing to see if potential new hires can perform job), and
  • Work reconditioning programs (and others....)
  • The reason I am writing to the ASEP members is because a few of the "Movers and Shakers" in this industry are Exercise Physiology trained.  Dr. Brent Ruiz, Vice President of ARCON, who trained me to perform Job Analysis and OSHA inspection walk-throughs, told me some time ago that exercise physiologists have many advantages in performing these functions and are a major asset to business and Industry.

    Occupational medicine services that tie into the ADA (started in 1992) can be a fairly new wing or service arena that exercise physiologists can venture into and be respected for their knowledge as well.  Although there are some people doing what I do, I would bet that exercise physiologists who are employed in full-scale occupational medicine comprise less than 10% of the total.

    Interestingly, as was pointed out in the ASEP website, exercise physiology is not just cardiac rehabilitation.  While I worked two years in cardiac rehabilitation, I must say that it wasn't that challenging for me.  In fact, I would probably have changed careers had I had stayed in it much longer.  In my opinion, I believe we are more than pulse checkers, met calculators, and ECG watchers!  While each can be challenging, collectively, it does not interest me.

    If there is an interest in Occupational Medicine and how exercise physiologists can get involved, I would love to address specific questions, topics, and so forth.  The services that I perform are normally done by physical therapists and/or occupational therapists at a higher wage rate (unfortunately) than I am getting paid.  On the positive side, however, I think that I may be paid better than most clinical exercise physiologists.

    I do not know the ASEP position on the subject, but I think that the universities are turning out too many exercise specialists or other variants of the same.  Most of these young, new grads almost certainly must get a master's degree to get a decent job, and still there are tons of them (if they are lucky) working at fitness and/or wellness centers making $7-11/hour!  Many of my friends teach at the high school level, even if it isn't in their field of study.  If we had a system like the therapists had a few years back that created a shortage of sorts, we may be in a different situation!

    The economy of scale is not in our favor right now.  As long as exercise physiologists accept the $7/hour fitness instructor position with a master's degree, the harder it will be to attain  professionalism.  However, what is in our favor is the aging population in the United States!  This fact will not change, but hopefully reimbursement will.

    I look forward to responding to questions ASEP members may have regarding occupational medicine via exercise physiology.


    Can ASEP Make a Difference?
    Dr. Mannie Hall

    Referencing your recent forum topic (3668 ASEP hits and 4 public opinion hits!) commentary, you ask a simple question -- What is the deal?

    The focus of ASEP concerning certification or registry should be on the role of the Exercise Physiologist (EP) within the health care system, especially managed care.  Why? Consider the following questions:

  • Is there a viable role for the EP as a patient care team member and (more importantly) will the insurance industry pay for the services rendered?
  • What is the leading cause of death in the United States?  Is it possibly heart disease?
  • Are 50% (1 out of 2) of the deaths attributed to heart disease?
  • Is heart disease associated with life-style choices over time?
  • Do certain primary risk factors contribute to heart disease?
  • Has the American Heart Association (AHA) recently added two new primary risk factors?  Could the new primary risk factors be physical inactivity and obesity?
  • Do EPs know something about exercise, body composition analysis, weight management, sports nutrition, and risk factor analysis?
  • Do physicians know very much about exercise prescriptions and body composition analysis?
  • Is the managed care system concerned about preventative medicine (also referred to as wellness)?  Does wellness save money?
  • Will the insurance companies pay for preventive medicine specialists (such as EPs)?
  • Is reimbursement important to this process?
  • Does it take both a national and "grass roots" effort at the state level to obtain reimbursement?
  • Is ASEP attempting to pursue the reimbursement option?
  • Is there a well defined list of competencies which articulate the skills and capabilities of EPs?  Where is the list?
  • Realistically, what can EPs do within the managed care system?  The answer is simple, but the process is difficult.  The national effort is noteworthy, but the state-by-state structure is very limited.  A quick fix may be Medicare, but the long term battle will be fought at the state level.  The trouble will be the aggressive opposition waged by PTs.

    ASEP needs CAAHEP (www.caahep.org), more members, and the respect of physicians.  ASEP needs to reach out to physicians and gain their support or understanding.  Also, it is very important for each exercise physiologist to answer the following questions:

  • Are we really professionals?
  • Can we define who we are and what we do?
  • Can patients or the public benefit from our knowledge.
  • Can we help people live longer and more productive lives?
  • Can EPs make a difference?

  • 2nd Annual
    Meeting of ASEP  (October 14-16, 1999) 




    Location - Albuquerque, New Mexico
    Conference Facility - Wyndham Hotel
    Inquiries -

    Robert A. Robergs, Ph.D., FASEP
    Conference Organizer
    President - ASEP
    Director – Center For Exercise And Applied Human Physiology
    Johnson Center, B143
    The University Of New Mexico
    Albuquerque, NM 87131-1258
    Phone: (secretary): (505) 277-2658
    FAX: (505) 277-9742
    Hosts -
    Exercise Science Program and the
    University of New Mexico Student Chapter of ASEP
    The University of New Mexico 
    ASEP TOC
    ASEP Public Forum for Exercise Physiologists
    Check it out!  Also, check out the following comments posted:
    Tue Mar 16 17:07:33 US/Central 1999. 


    Response to Stature in the Medical Community
    Kelly O'Reilly

    Greetings from Houston. I am contributing to this forum as an opportunity to vent some of my own frustrations with this field. I have just recently stumbled upon ASEP and am optimistic about its potential. I have read much of Dr. Boone's writing on the state of exercise physiologists in today's working world. I felt like he was reading my mind regarding the many concerns that face our field.

    I consider myself a clinical exercise physiologist since I primarily work in cardiology, doing cardiac rehab and exercise testing. I share in the frustrations of not being recognized by co-workers, physicians, patients, etc. and do not have a very good answer for the inevitable "what does an exercise physiologist do?" Jokingly, I often say I am a non-entity in the medical field, but unfortunately that has a large ring of truth to it.

    The issues I am most concerned about are: licensing/certification; degree recognition; degree program structures; and, with reticence, titles. These issues are intertwined and it is hard to talk about one without bringing points in from the others. I think the "title issue" has less to do with the degree earned and more to do with licensure or certification. I don't know which one would be better, but I do see the need to set a standard, regardless of what it's called.

    I was thinking about other fields like engineering, teaching, PT, nursing, psychology, Social Workers... they all have various degree levels and different areas of specialization. The one recurring theme I kept landing on was a way for them to achieve recognition from peers, employers, and the general public... a LICENCE or CERTIFICATION of some sort. I suppose if you had a degree in physical therapy you could call yourself a PT but no hospital would hire you without a license, as with teachers, nurses, etc.

    I believe all of these fields are "recognized" at the state level, with fairly straightforward reciprocity between states. My guess would be that there are federal governing principles for each state to follow, probably brought forth by a well-in-tuned organization as an advocate (possibly like ASEP?). So I strongly believe we need a method of recognition also. This would help alleviate some of the dissent about degree status. Institutions could use licensing as a basic structure and then delineate salary status based on degree (as is often done in nursing).

    At least ACSM is on the right track with their certifications. Although, one of the problems I have had with ACSM is that, while they do have certifications in different areas (which I think are along the right lines), NOBODY cares. Or at least, not very many cardiac rehab programs I have known. ACSM is not recognized as a governing body, especially with respect to legal issues in the medical field and it makes little difference in the job market if you are certified or not. It also makes little difference to the insurance companies and reimbursement factors. So why spend the $600?

    I have many other thoughts but have to close for now. I will keep my eye on ASEP and this forum in hopes we can help each other establish solid, productive, and satisfying career paths. 


    Professionalization
    As you may know, letters were sent to specific ASEP members requesting their thoughts and ideas in written form to be published in the Professionalization of Exercise Physiologyonline journal.

    Hello everyone!!!! Heads up, with a smile!!!!!
    We have THREE papers submitted:

  • Shane Paulson, MA
  • Lance Tarr, MS, CSCS
  • Elaine George, MA
  • Their thoughts about EXERCISE PHYSIOLOGY can be found in the March and April issues of PEPonline.

    Interesting Web Sites
    Have you run across an interesting exercise physiology site?  If you have and would like it to be posted, please let me know via my email.

  • Take a look at this web site.  It belongs to an ASEP member!
  • You may also want to take a look at JC's  web site.  His world of exercise physiology!
  • Clinical aspects of exercise physiology.
  • Melissa Knight-Maloney
  • HMS Beagle (The BioMedNet Magazine)
  • Miningco.com (Guide to Sports Medicine with links to Exercise Physiology)

  • ASEP, Professionalism, and Standards
    Tommy Boone, PhD, MPH, FASEP

    Health, fitness, sport, and rehabilitation organizations can be found on the internet.  They diligently market themselves and their product or service.  They understand that persistence in marketing efforts is imperative to success.  They aren't going away.

    However, what are they promoting or selling and why do they have members?  What do they offer that is important to their target market?  Who is likely to want the service or association?  What can ASEP do to gain an edge over the competition for exercise physiologists?  These are important questions that need answers if ASEP is to find an edge on the competition.

    In short, ASEP's value to exercise physiologists is that it gives them an edge over their competition.  How?  Because ASEP exists to promote exercise physiologists and only exercise physiologists.  Because it will (by October, 1999) provide the only national certification for academically prepared exercise physiologists.  Because it exists to think about and analyze present and future issues to improve the profession.  ASEP is a success because the members "thought" they could make a difference.

    Profile of an ASEP Member
    Do you have the key traits of an ASEP member?  Have you thought about joining ASEP?  Do you know what it takes to be an ASEP member?  I've thought about the ASEP member, where they live and work, the people with whom they work with, and why they became an ASEP member.  I can't say that I have the answers, but my sense is that they are looking for new opportunities, hope, and respect for what they do.

    Every week I talk with other exercise physiologists who tell me how excited they are about ASEP.  Usually, their comments include something like, "We need this organization.  It is time to define who we are and what we do."  They believe it will bring professionalism to exercise physiology.

    Who are they?  They are the undergraduate and graduate students from colleges all over the United States.  They are the bachelor and master prepared professionals in health, fitness, and rehabilitation centers who have common characteristics and similar problems.  They are the PhD exercise physiologists who are compelled to find a better solution to their problems than that which has been defined by sports medicine.

    ASEP is the organization for the development of exercise physiologists.  It is about our self-image, and our future.  With hard work and our imaging skills, we will produce positive results.  Visualization is important to realizing possibilities in the future.  For example, picture the way you prefer to be in the future.  Then, take action to invent the future.  It isn't as crazy as it sounds.  We become what we think about (Earl Nightingale).

    Success is not determined by what is, but by what we think.  Stated differently, what you think is what you get.  What is your vision, hope, and dream?  "Without a vision, people perish" (Proverbs).  Develop a vision for your professional work.  Write it down and do something everyday to realize it in your professional work.

    Exercise physiologists with a vision survive.  Why?  Because a vision provides the purpose and the strength to visualize a better future.  The ASEP Vision is:

    1. To be recognized as the leading professional organization of American scholars and practitioners in the study and application of exercise physiology to fitness, health promotion, rehabilitation, and sports training.

    2. The Society is dedicated to unifying all exercise physiologists in the United States and worldwide to promote and support the study, practice, teaching, research, and development of the exercise physiology profession.

    3. Through proactive and creative leadership, the Society empowers its members to serve the public good by making an academically sound difference in the application of exercise physiology concepts and insights.

    Think positive and dream of the day when all exercise physiologists, not just the PhD exercise physiologists, will have the same chance of success.  Don't be afraid of joining ASEP or asking questions to fine tune your outlook.  Analyze and identify the experts who are willing to help.  Dedicate yourself to "never giving up" because "results come to those who put in the effort, there is no other way" (Walde, //Ricnum.net/article147.html).

    Professionalism and Standards
    Through the work of ASEP Accreditation Committee, a national effort is underway to develop national educational standards.  The importance of establishing standards is obvious to those who have either studied the problem or living the problem.  It is a question of integrity.  Do we continue with the same sinking lifeboat or do we jump out and swim for our integrity.

    To ASEP members, it is imperative that they implement an exercise physiology curriculum to complement the ongoing professionalization of exercise physiology.  To those who don't understand, they look upon the ASEP agenda with suspicion.  Whether viewed as hope or threat, the standards are important to establishing exercise physiology as a profession.  National accreditation, state licensing of exercise physiologists, academically-grounded certification of exercise physiologists are necessary steps in professions regulating themselves.  The public sector is thus assured that the exercise physiologist operates according to established standards of practice.

    The American Society of Exercise Physiologists is leading the effort to professionalize exercise physiology.  Most importantly will be the emphasis placed on courses and content expectations for teachers and students.  In time, there will also be emphasis placed on new accreditation standards for teacher preparation.  Exercise physiology teachers will have to demonstrate specific skills and, in particular, apply exercise physiology concepts and strategies to the public sector.  There will be increased emphasis on problem-solving and critical thinking skills.

    The new standards will have a profound influence on the professional development of exercise physiology.  It will encourage new relationships with state and federal agencies, increase the likelihood of reforms linked to public needs, and facilitate coordination between ASEP and other professional organizations.  The newly created, dynamic affiliation and partnership with organizations world wide will encourage an integrated understanding of the importance of exercise physiologists to health, fitness, sports, and rehabilitation.

    ASEP is the force behind this revolution of professional-development.  With the graduates' ability to demonstrate specific knowledge and research skills, the public's view of the profession will evolve accordingly.

    The professionalization of exercise physiology is a reality.  National certification, accreditation, standards, and a scope of practice will increase the probability that all exercise physiologists will access good paying jobs where they are treated with respect and admiration for their requisite body of knowledge and skills.


    ASEP Table of Contents