From Specialised Health’s Exercise Physiologist, Jennifer Smallridge
In our previous newsletter (click here to go back and check it out), we gave a comprehensive background on Physical Inactivity Awareness Month and the widespread epidemic of insufficient movement in Australia. In this update, we relate this back to the Insurance industry and explain how increasing physical activity can have a positive flow on effect to other areas of health, how exercise physiologists facilitate this behaviour change and how case management strategies can be improved as a result.
Determining the drivers for change
Knowledge around the benefits of exercise is the tip of the iceberg when it comes to making sustainable behaviour change. Exercise physiologists are specifically trained in behavioural psychology strategies, such as motivational interviewing, to elicit desired outcomes, particularly in a previously ‘unmotivated’ individual.
Whilst obtaining a subjective history, Exercise Physiologists are constantly assessing for cues that may give us a hint about which stage of change this person might be in. Are they completely inactive and unaware of how to exercise for their condition, or do they occasionally walk the dog? Are they voicing or alluding to any barriers, real or perceived? What about the enablers – do they have positive social support in their life? When you make a referral to exercise physiology, you can rest assured that these factors are being taken into consideration when devising an effective conditioning program.
An Exercise Physiologist’s toolkit
Rather than a simple ‘set and forget’ work conditioning program, exercise physiologists use a variety of evidence-based strategies to increase adherence and maximise results. These may include, but are not limited to:
- Subjective self-report diaries of exercise, mood, sleep, nutrition, energy levels
- Objective measures such as pedometers and activity trackers
- Access to suitable equipment within the home setting, or appropriate facilities through a gym membership
- Devices such as the iThlete to track nervous system recovery, particularly in the fatigue cohort
- Online integrated systems such as Physitrack which provide videos of prescribed exercises and enable practitioner-customer communication
More than movement
Engaging in supervised physical activity on a regular basis can bring about more than lifting capacity or cardiovascular fitness. Some of the ‘behind-the-scenes’ benefits of service provision include the following:
If an individual has been off work for a while and checks in with their GP or specialist sporadically; exercise physiology appointments can serve as a useful re-integration into activity scheduling and responsibility. The time of day that the appointment occurs can also provide a good gauge of function; particularly if sessions have moved from late in the day to early morning appointments.
Self-efficacy is defined as one’s belief in their ability to complete a task successfully, even in the face of barriers. Work conditioning programs are one of many ways of boosting self-efficacy, by being set a task (regular, targeted exercise) to complete when there may be acknowledged obstacles (fatigue, pain, low motivation). Anecdotally, this factor has been known to improve engagement in other areas of life; from good nutrition, to sleep hygiene, to job seeking. There are validated measures around exercise self-efficacy available which capture this information and can also prove helpful when assessing program impact.
- Constant communication
Through formal reports and more informal updating, exercise physiologists can provide information that may not have been previously known, particularly if there has been communication issues in the past. Each health professional adds another ‘set of eyes’ to gather data pertaining to the presentation, capacity, and overall wellbeing of the patient. We are in a unique position to be able to see people in the home, gym or work environment actually performing their required tasks, which allows the customer to build confidence in their own abilities and also allows others such as the GP, Rehab Provider and Insurer to strategise accordingly and potentially offer services to the client which are more aligned with their goals, abilities and beliefs.
The take home message:
The National Physical Guidelines recommend 150 minutes of moderate-intensity physical activity per week for good health, and it is the goal of any intervention to reach this target in a way that meets specific customer needs. Exercise physiologists possess not only the knowledge but the how-to when it comes to promoting long term change.
Mirotznik, J., Ginzler, E., Zagon, G. and Baptiste, A., 1998. Using the health belief model to explain clinic appointment-keeping for the management of a chronic disease condition. Journal of community health, 23(3), pp.195-210.
Marcus, B.H., Selby, V.C., Niaura, R.S. and Rossi, J.S., 1992. Self-efficacy and the stages of exercise behavior change. Research quarterly for exercise and sport, 63(1), pp.60-66.