PEPonline Professionalization of Exercise Physiologyonline An international electronic journal for exercise physiologists ISSN 1099-5862 Vol 3 No 8 August 2000   Exercise Physiology -  The Legacy With Clinical Areas A. GOSWAMI, PhD Sports Authority of India Netaji Subhas Western Center Gandhinagar, Gujarat, India The word `PHYSIOLOGY' was first used by the Greeks during 600 BC to describe a philosophical inquiry into the nature of things.  Use of this word, to refer the vital activities of healthy humans, began in the century.  The ideas of Aristotle and Galen were the first efforts in physiology.  Galen, who lived from 130 to 200, concerned himself both with anatomy and with what today we call medical physiology (1).  Modern physiology took off from the works of William Harvey (1578-1657).  The reader may recall that Harvey observed in the early 1600s that the beating heart expels the blood within it.  Curiosity, medical necessity, and economic interest stimulated research on the functional aspects of living things and created a wider definition of physiology.  The efforts of Claude Bernard (1813-1878, of France), J. Muller, J. von Liebig and C. Ludwig (1801-1895, of Germany) and Sir M. Foster (in England) had produced the necessary insight for this wider definition.  It was implied that ideas of physical sciences should be used with experimental methods to investigate the causes and mechanisms of the activities of all living things (1).  Today, the word `PHYSIOLOGY' means the study of the structural and functional aspects of the living organisms.  Because of the interest in disease processes, physiology has also aided our understanding of the study of modern medicine (2). This brief introduction to physiology suggests that exercise physiology also shares a relationship with medicine.  But like physiology across time, its boundaries are at times poorly defined and its scope is as broad as one's imagination.  Though physiology's central disciplines are recognized, physiology per se has cut across the lines of traditional biological disciplines.  The complexit of the human body has, however, resulted a number of super specialized fields of study (such as biochemistry, biotechnology, endocrinology, and the like).  The development of these specialized fields has made one thing clear.  As specialization occurs, areas of work in the main field become increasingly more restricted.  Exercise physiology is one such specialized field of study that is itself an independent area of investigation and work that for most part exists under a variety of different names.  In this case, the different names, different academic settings, and the primary fact that exercise physiology is generally not pursued in the typical physiology departments suggest that exercise physiology is something unique from physiology per se.  Although physiology has for centuries been related to medicine, the relationship does not mean an automatic one exists with exercise physiology.  Yet, today, many exercise phsyiologists work in the clinical areas, including in particular cardiopulmonary rehabilitation.  In general, then, the question is to what extent do the exercise physiologists have a right to prescribe anything?  A second, perhaps, equally important question is whether the prescribing of medicine is necessary to professional status and/or the proper acceptance and recognition by one's colleagues?  Clearly, medical graduates are certified and registered to prescribe medicines.  Exercise physiologists (and physiologists) are not certified in a similar way.  Detailed examination of the present status of physiology, more specifically exercise physiology, reveals that the idea of prescribing "something" by a clinician is not always, by definition, exactly clinical. For example, consider the following conditions:  (a) Body weight control through exercise and diet control is a kind of "physiological manipulation" that has no connection with medicine. Therefore, for some exercise physiologists, the question is "Why is it that this kind of therapeutic measure can not be prescribed by exercise physiologists?"  Of course it is understandable that an exercise prescription by a half-educated therapist could be dangerous and life threatening. Take the case of the overweight CHD patient. An overdose of exercise can create obvious problems.  (b) Several naturally available compounds are now listed as pharmaceutical products. Vitamins, for example, are essential for the body.  These are either produced in the body or drived from food.  Why is it that the prescription of food specialties should fall only in the hands of clinical practitioners?  (c) Alternative medicine practictioners use natural products to treat a variety of conditions. Why aren't these products and the treatments considered physiological treatments?  There are many such examples in the literature and in real life.  The term "medicine" is very attractive to the general population.  So, to raise the status of a particular discipline to the level of being "medicine-like" becomes an important attachment.  Take physiotherapy as an example, most of the medicine-like methods used are actually physiological manipulations. Still, in many countries, most people are aware of the difference between `Physiology' and `Physiotherapy'.  Despite the organizational complexity of the two disciplines, the facts are they are different.  Physiology has donated essentially everything to the other areas and yet the areas covered under physiology per se have narrowed.  Similarly, exercise physiology, in its own way (both historically and through its own research), has set the stage for physical therapists, nurses, and occupational therapists to engage in cardiopulmonary rehabilitation.  We should remember that multiplication of `Hydra' makes it difficult to recognize the primary one, because the primary hydra gives birth to many similar specimens and remains one of them.  So, before we de-attach ourselves from medical field, a serious thought must be given to the idea:  "Exercise physiologists are physiologists in the first place, right!  Or, is it that they are only exercise physiologists!"  It may be important to recognize physiology as a basic science for many schools of thinking before exercise physiology can be a basic science itself. References 1. Beck, W.S. (1971). Human Design: Molecular, Cellular, and Systematic Physiology. New York, NY: Harcourt Brace Jovanovich, Inc.  2. Fox, S.I. (1996). Human Physiology. 5th edition. Dubuque, IA: Wm.C. Brown Publishers. Copyright ©1997-2000 American Society of Exercise Physiologists. All Rights Reserved.   ASEP Table of Contents Questions/comments