LearningFromHistory

Professional identity is important within academia. It is also imperative to practitioners. Exercise physiology as a discipline and as a profession has a problem. The recent columns in the ASEP Newsletter [1] and the Professionalization of Exercise Physiologyonline[2] attest to this. To understand the problem one really needs to examine the heritage of exercise physiology in modern academia and the public’s perception.

In 1961 the state of California responded to an emerging concept within education by passing the Fisher Act [3]. This act required that all departments within state universities have an underpinning academic or scholarly base. At that point in time, the pool of science and practical knowledge that defined physical education as an evidence-based discipline was sparse. The implication was that university preparation was not required to be an effective physical educator. While potentially catastrophic to university physical education programs, this was a boon to public school administrators. Since physical education was not considered an academic endeavor, it could be taught by anyone or even be eliminated from the curriculum (and save money).

At the time of the Fisher Act, the epidemic of obesity and sedentarism had not yet become a public health issue. Just look at the physical education requirements in public schools during the 1950s versus the 1980s, and even to this day, and you will see the results of the persistent belief in the low value of physical education and its practitioners. For example, either there is essentially no emphasis placed on physical education or there are no requirements at all.

A direct response by academics to the Fisher Act was to make physical education more scientifically based. This required the development of a unique body of knowledge; a task embraced by the physical education community. An outgrowth of this new emphasis was the unintentional fragmentation of the academic major in physical education (i.e., biomechanics, exercise psychology, sports history, sport sociology, motor control, and exercise physiology). Practitioners within each sub-discipline produced important and sustainable scientific information that contributed to the salvation of physical education programs.

Unexpectedly, something else occurred as well. Each of the sub-disciplines developed into its own unique identity. Some even ascended to the level that warranted their own departments with their own terminally degreed disciplinary faculty. However, most sub-disciplines remained within the physical education department. Understandably, the primary objective of these departments is to graduate physical educators and coaches.

Although the sub-disciplines produced an important body of knowledge that is useful to not only physical educators but to the medical community as well, little to nothing beyond publishing in academic journals was done to dissipate the popular and academic perception of physical education as academic fluff. Thus, began the era of “running from the stench of the jock strap,” as one ex-president of AAHPERD has so eloquently stated. This was manifested as an attempt to be considered separate from physical education and this set the stage for the use of more scientific sounding titles for identifying departments.

Now, rather than a Department of Physical Education, it was called the Department of Kinesiology or one of a dozen other department titles, such as Exercise Science, Human Movement Studies, Human Performance, or Health and Human Performance. The Department of Exercise Science, in particular, became a commonly used title to mark recently renovated Department’s of Physical Education. After all, exercise “science” supported the notion of a new evidence-based philosophy. But a rose is a rose by any other name.

Without a complete separation from physical education, the newly named departments were (and are) predestined to be known by students, colleagues, and the public as PE departments. Even the alphabet soup of departmental and sub-disciplinary names could not and cannot change this. To this end, many traditional physical education departments at larger institutions have dropped their physical education components in favor of becoming exercise science research and clinical education units. There are even some exercise physiology programs now housed within traditional biology departments. This is a forward thinking option. But, it still confuses the identity of exercise physiologists, what they do, and where they belong.

An unfortunate side-effect of the physical educator’s search for identity and academic acceptance is the confusion that exists in respect to “exercise physiology.” As a field of study or research, the usual definitions of exercise physiology are cursory and varied:

A branch of exercise science, where individuals have specialized into either health and fitness or exercise rehabilitation streams [4].
Study of how exercise alters the structure and function of the human body [5].
A branch of physiology that deals with the functioning of the body during exercise [6].
A basic and an applied science that describes, explains, and uses the body’s response to exercise and adaptation to exercise training to maximize human physical potential [7].
In Astrand and Rodahl’s classic 1970 book, Textbook of Work Physiology, the term exercise physiology is not used or defined [8].

Although these definitions may approximate an adequate definition of the discipline, they do not adequately detail the profession of exercise physiology. Also, it isn’t possible to build a profession on the basis of these cursory descriptions. Yet, this is the only face of exercise physiology presented to students and others (including the public sector). As written, these definitions cannot establish a discrete identity recognizable by the public, students, and academia. The differences between exercise physiology, sport physiology, exercise science, sports science, physical education, and many others are lost in the quagmire of convenient terminology that exists in most academic departments. As a result, efforts towards the professionalization of exercise physiology are difficult as the public, the political machine (remember that politicians greatly affect the steps of professionalization and licensure), and colleagues do not know the answer to “what is exercise physiology” and “who is an exercise physiologist.”

The starting point to correct this is to arrive at a common set of descriptors that adequately encompasses the characteristics of exercise physiology. Of course, these descriptors must make sense to practitioners, politicians, and the public alike. This is not an easy task given the wide range of preparation, skills, and duties that may be associated with an exercise physiologist. It is useful to consider definitions of “exercise science” and “sports science” in advance of proposing to define exercise physiology:

Exercise Science – An integrated discipline drawn from biology, chemistry, and physics that intends to provide scientific basics to physical educators, personal trainers, athletic trainers, and coaches in order that they might understand how their practical interventions affect the human body. It is common to find hybrid courses within this discipline merging two or more fields of study (i.e., anatomy and physics for a “kinesiology” course). Owing to the lower level of detail required to accomplish the academic purposes of this discipline, generalist faculty from non-research based graduate programs in exercise science or physical education are frequently employed rather than having a biologist teach physiology or a physicist teach biomechanics. This latter fine point leads to faculty holding positions within this discipline coming from a variety of doctoral programs (physical education, exercise science, kinesiology, physiology, and biomechanics) and they generally focus primarily on teaching rather than on discovery, as would be a requisite for a science department at a Carnegie Category I institution.

Sports Science – See “Exercise Science” definition with respect only to sport performance, a subtle difference.

As most college and university academic programs are not confined specifically to one or the other, exercise or sports, it may be more relevant to term this type of faculty and program as “sport and exercise science.” Within larger programs where discovery is an emphasis, there may be a need to describe component programs and specialized faculty (e.g., exercise physiology, biomechanics, and exercise psychology). There may also exist the need to consider how the differing goals of the areas of emphases within exercise physiology (research, teaching, performance enhancement, and clinical practice) are to be defined, as a unified description or as discrete entities. There seems to be a logical division within the potential definitions that centers on clinical practice versus sports performance:

Exercise Physiology – This is a biology based and fairly well defined academic discipline but a relatively poorly defined profession. At the bachelor and masters level, it generally refers to a clinically oriented profession that uses evidence-based exercise programs as a preventive or therapeutic modality. The term “clinical exercise physiology” seems to be synonymous. At the doctoral level, an exercise physiologist must have been produced by a doctoral program whose main emphasis is disciplinary (physiological) research. These faculty may occupy positions in research-based programs in a variety of departments (such as exercise physiology, kinesiology, physiology, or biology) and function as exercise physiologists in research. Such exercise physiologists, by training, may also occupy positions within “Exercise Science” programs where they function as exercise scientists teaching. They may also enter the clinical arena and function as clinical exercise physiologists.

Sports Physiology – This is also a biology based and fairly well defined discipline with a very poorly defined professional component. At the bachelor and masters level, it generally refers to a sport oriented profession that uses evidence based exercise as a preparatory modality for enhancing sports performance. At the doctoral level there are really no programs focused on producing sports physiologists. The end result is that some exercise physiologists choose to utilize their education and training to explore sports performance. Sports physiologists may occupy positions within either “Exercise Science” programs teaching or within research-based programs in a variety of departments (kinesiology, physiology, biology, etc.). There are very few true “sports physiologists” at any level given: (A) the lack of specific educational programs producing so trained faculty; (B) that so very few physical education and related programs have a sports specific educational track; and (C) the lack professional opportunities available to sports physiologists in academia or business. Sports Physiology vs. Exercise Physiology is a topic requiring separate specific attention, especially if “exercise physiologists” propose to practice in the sports physiological arena. See the paper by Mike Stone in the Strength and Conditioning Journal [9] for a good description of these important and related problems.

These divisions fail to adequately define exercise physiology associated with basic fitness. Although improvements in fitness are performance enhancements, there is quite a divergent body of research and practices between exercise for fitness and exercise to win an Olympic medal. Further, rehabilitation physiology, that is, the physiology of injured and diseased tissue is greatly different in approach and intended outcome from either of the two aforementioned areas of study and practice, which raises several questions:

As professionals, exercise physiologists must evaluate and define where we fit (personally, as university departments or programs, and as a professional organization) within the constructs of our existing educational and professional systems.
Can a traditional program producing physical educators and coaches also effectively produce exercise physiologists?
Should exercise physiology be an overarching term that is inclusive of physiology related to fitness, health, sports performance, and clinical rehabilitation?
Should exercise physiology programs be independent academic units with a declared academic major?
Should exercise physiology programs be housed in colleges of education, allied health, or sciences?
Should an exercise physiologist be a master-trained practitioner in the mold of physical therapists and physicians assistants?
Is a professional certification such as the ASEP Exercise Physiologist an absolute requisite characteristic of a practicing exercise physiologist?
Should separate endorsements or certifications, specific to areas of professional practice (sport, clinical, health and fitness), be required given the divergent goals and supporting research of each group of practitioners?

As a professoriate, as researchers, as teachers, and as practitioners, exercise physiologists must address these questions openly, honestly, and without imposing personal bias. They must do this in support of the movement towards both recognition and professionalization of exercise physiology. Answers to these questions, if publicized, will help position exercise physiology for acceptance and recognition within academia and the public consciousness. Dissemination of this information in a widely approachable form or forms is imperative. Every single academic and practitioner associated with sport and exercise must move towards combating the myth that if you are fit, you know everything there is about being an exercise professional, including being an exercise physiologist.

Daily, our students, our peers, and the population as a whole are inundated with misinformation in the media. This can best be exemplified by an article and cover quote from a popular fitness magazine. A famous actor is quoted, on the cover, saying “I’m not going to listen to someone who’s not in better shape than I am” [10]. Where are the exercise physiologist’s quotes, or any exercise practitioner’s quotes for that matter, to counter such professionally harmful statements? Members of professional organizations and academics must enter the realm of popular media if we hope to move forward. We cannot confine what we do only to academic journals and texts.

The American Society of Exercise Physiologists has taken a progressive approach to the professionalization problem and has posed the following definitions [11]:

Exercise Science - A diverse field of study that may include sport psychologists, exercise physiologists, biomechanists, physical educators, and kinesiologists.

Exercise Physiology - The identification of physiological mechanisms underlying physical activity, the comprehensive delivery of treatment services concerned with the analysis, improvement, and maintenance of health and fitness, rehabilitation of heart disease and other chronic diseases and/or disabilities, and the professional guidance and counsel of athletes and others interested in athletics, sports training, and human adaptability to acute and chronic exercise.

Exercise Physiologist - A person who has an academic degree in exercise physiology, or who is certified by ASEP to practice exercise physiology [via the Exercise Physiologist Certified exam (EPC)], or who has a doctorate degree with an academic degree or emphasis in exercise physiology from an accredited college or university.

This is a progressive start that requires continued nurturing, clarification, then media exposure. As written, the ASEP definitions imply that the practicing exercise physiologist must be trained and competent to practice as a clinician, a personal trainer, and a coach. This is a tremendous challenge to academic units. Beyond academia, these definitions will influence the development of the profession of exercise physiology. So, we must be certain of their content and validity to ASEP’s members and certificants in order to ensure a higher chance of recognition and adoption by other professional entities, academia, and the public.

Exercise physiology has come a long way since the days of the Departments of Physical Education. Self definition is essential to further progress. Limiting self-definitions to what exercise physiology is and what exercise physiologists are educated to do rather than “what could be” is also central to progress and to public and political acceptance. We cannot be all things to all people. Fortunately, there are indications of light at the end of the tunnel. The membership of ASEP is dedicated to professional unity, shared communication, novel approaches and ideas, and to self-regulation; the true beginnings of professionalization.

References

Lowery, L. (2006). Exercise Science: Now I Understand. ASEPNewsletter. 10:1 [Online]. http://www.exercisephysiologists.com/ASEPNewsletter/index.html#Editorial
Boone, T. (2005). The Cost of Not Knowing (2005). Professionalization in Exercise Physiologyonline. 8:9 [Online]. http://www.asep.org/asep/asep/TheCostOfNotKnowing.html
Inglis, S.A. (1961). Specialized Interests Challenge the Fisher Act: 1961-1965. California Commission of Teacher Credentialing. [Online]. http://www.ctc.ca.gov/commission/history/1961-1965-Specialized-Int.pdf
Wikipedia. (2006). The Free Encyclopedia. [Online]. http://en.wikipedia.org/wiki/Exercise_physiology
Robergs, R.A. and Scott, O.R. (1997). Exercise Physiology: Exercise, Performance, and Clinical Applications. St. Louis, MO:Mosby-Year Book, Inc.
Brooks, G.A., Thomas, D.F., Timothy, P.W., and Kenneth, M.B. (2000). Exercise Physiology: Human Bioenergetics and its Applications. (3rd Edition). Mountain View, CA: Mayfield Publishing Company.
Plowman, S.A. and Denise, L.S. (1997). Exercise Physiology for Health, Fitness, and Performance. Needham Heights, MA:Allyn and Bacon.
Astrand, P-O. and Kaare, R. (1970). Textbook of Work Physiology. New York, NY: McGraw-Hill Book Company.
Stone, M.H., William, A.S., and Margaret, E.S. (2004). The Downfall of Sports Science in the United States. Strength and Conditioning Journal. 26:2:72-75.
Zimmerman, M. (2005). The Evolution of Mark Wahlberg. Men’s Health. September, 194-197.
American Society of Exercise Physiologists. (2006). The ASEP vision. [Online]. http://www.asep.org/vision.htm