Andrew Scott

Professional standards are used to inform and measure educational programs and individual credentialling of many professions, including those in allied health. The objective of this project was to develop consensus on international professional standards for clinical exercise physiologists. The project employed an e-Delphi approach to build a consensus, being guided by a steering committee and an expert working group. The expert working group reviewed the elements and the steering committee overviewed the results of each round. The expert working group were invited to consider whether elements should be included or excluded and, if to be included, whether these should be core or non-core. The wording of the elements was also checked for accuracy. To be included in the end professional standards and as core, each element required 80% consensus from the expert working group. The e-Delphi process found consensus on four overarching professional standard domains for clinical exercise physiology: professional practice; foundational knowledge; assessment and client management; and case formulation and design and delivery of evidence-based interventions. Consensus was also achieved on individual elements. All bar two of the elements were accepted as core, with these two both being included in the professional standards since they were close to meeting the 80% consensus threshold and because they are reflected in the clinical exercise physiology professional standards where this profession is established. The international professional standards consensus has been achieved with the aim of supporting the development of a standardised approach to international education and practice in clinical exercise physiology.

In 2021, a ‘call to action’ was published to highlight the need for professional regulation of clinical exercise physiologists to be established within UK healthcare systems to ensure patient safety and align training and regulation with other health professions. This manuscript provides a progress report on the actions that Clinical Exercise Physiology UK (CEP-UK) has undertaken over the past 4 years, during which time clinical exercise physiologists have implemented regulation and gained formal recognition as healthcare professionals in the UK. An overview of the consultation process involved in creating a regulated health profession, notably the development of policies and procedures for both individual registration and institutional master’s degree (MSc) accreditation is outlined. Additionally, the process for developing an industry-recognised scope of practice, a university MSc-level curriculum framework, the Academy for Healthcare Science Practitioner standards of proficiency and Continuing Professional Development opportunities is included. We outline the significant activities and milestones undertaken by CEP-UK and provide insight and clarity for other health professionals to understand the training and registration process for a clinical exercise physiologist in the UK. Finally, we include short, medium and long-term objectives for the future advocacy development of this workforce in the UK.

Research has evidenced that regular exercise can provide physical and physiological benefits for people living with stroke. Our study aims to explore the experiences of people living with stroke when participating in a community physical activity programme. This programme was created to offer targeted physical activity and education interventions following the discharge of patients from the healthcare pathway. This qualitative study involved semi-structured interviews with 16 participants living with stroke who were recruited from individuals who had engaged with the activity programme. A reflexive thematic analysis was conducted on the data, and four overarching themes were developed: (i) Feelings of appreciation, (ii) Interactions with other patients, (iii) Positive contributions of trained instructors, and iv) Personal progress. Generally, participants reported very positive perceptions of the exercise programme, and were very grateful for the opportunity that the exercise classes provided. We hope that these findings will offer practical suggestions for healthcare providers who might develop similar activity programmes for clinical populations.

As traditional education transitioned from face-to-face interactions to virtual learning during the COVID-19 pandemic, faculty and staff in dental hygiene, nursing, and exercise science programs placed students at the center of every educational decision and promoted stability in learning with their commitments to excellence in teaching and the delivery of content using educational and communication technology. This experiential narrative review explains how faculty members and administrators addressed online education with technology specific to health professions and how universities managed to assist students with innovative services for mental health. It also provides an insight into how degree-specific academic personnel embraced technology-based hands-on activities in community health clinics and clinical laboratories, with sustainable and impactful lessons in equity, affordability, and transformative education. Finally, health administrators gather their top-10 leadership recommendations to continue moving forward during the pandemic and present a unique self-reflection on the process of caring considerations required for a successful experience for faculty members, staff, and students.

Introduction The impact of the COVID-19 pandemic (caused by the SARS-CoV-2 virus) on individuals with cancer has been profound. It has led to increased anxiety, distress and deconditioning due to reduced physical activity. We aim to investigate whether SafeFit, a multimodal intervention of physical activity, nutrition and psychological support delivered virtually by cancer exercise specialists (CES), can improve physical and emotional functionings during the COVID-19 pandemic. Methods and analysis A phase III non-randomised intervention trial, target recruitment of 1050 adults with suspected or confirmed diagnosis of cancer. All recruited participants will receive the multimodal intervention delivered by CES for 6 months. Sessions will be delivered 1-to-1 using telephone/video conferencing consultations. CES will work with each participant to devise a personalised programme of (1) physical activity, (2) basic dietary advice and (3) psychological support, all underpinned by behaviour change support. Primary outcome Physical and emotional functioning as measured by the European Organisation for Research and Treatment of Cancer-Quality of Life Questionnaire (EORTC-QLQ-C30). Secondary outcomes: overall quality of life measured by EORTC-QLQ-C30 and EQ-5D-5L, health economics, patient activation, self-efficacy to self-manage chronic disease, distress, impact of COVID-19 on emotional functioning, self-reported physical activity, functional capacity and nutrition. Adherence to the intervention will also be measured and a process evaluation conducted. Ethics and dissemination Ethical approval was obtained from the Health Research Authority (reference number 20/NW/0254). Results of this trial will be disseminated through publication of peer-reviewed articles, presentations at scientific conferences, and to the public and people with cancer in collaboration with our patient and public involvement representatives and partners. Trial registration number NCT04425616.

Clinical Exercise Science is an introduction to core principles and best practice in exercise science for students and practitioners working with clinical populations. Combining the latest scientific research with evidence-based, practitioner-led analysis, the book offers integrated coverage of the full clinical exercise curriculum, including: Pathophysiology of exercise and disease Exercise as a clinical intervention Exercise, nutrition, and lifestyle Health behaviour change Clinical skills in exercise science The book covers a wide range of conditions, including cardiovascular disease, pulmonary disease, metabolic disease and mental health problems, and includes an array of useful features to guide student learning, such as case studies, study tasks, definitions of key terms and suggestions for further reading. With contributions from leading researchers and health practitioners, this is an invaluable foundation text for any clinical exercise science course, and useful reading for any student or practitioner working in exercise science, exercise rehabilitation, health science or physical therapy.