CLINICAL EXERCISE PHYSIOLOGY NEW ZEALAND
COMPETENCY STANDARDS
5. Musculoskeletal & Orthopaedic
6. Neurological & Neuromuscular
8. Immune & Haematological Disorders
1. NON-DIAGNOSIS-SPECIFIC
1.1 An understanding of the physiological responses and health hazards due to physical inactivity in disease conditions and individuals of all ages including children and the frail elderly (where appropriate refer to diagnosis-specific competencies below). The benefits of, and responses to exercise, and the recognition of, and appropriate responses to abnormal signs and symptoms during exercise.
Evidence:
Demonstrates knowledge of normal and abnormal responses to exercise.
Demonstrates knowledge of appropriate responses to abnormal signs and symptoms.
The ability to differentiate between a deconditioned individual’s response to exercise and an abnormal response to exercise requiring medical evaluation.
1.2 An understanding of health appraisal (history and prognosis) and risk stratification, design and implementation, incremental goal setting, and the ability to conduct fitness and health appraisals.
Evidence:
Demonstrates knowledge of components of a health appraisal and risk stratification, their purpose, and data interpretation.
The ability to use data to plan an incremental exercise programme design, including goal setting that is appropriate, realistic and measurable.
Demonstrates an understanding of exercise prescription progression, goal setting using the SMART guide (specific, measurable, attractive, realistic, and timely), and behaviour modification.
Ability to use SOAP notes as part of the client/patient assessment and rehabilitation management process.
1.3 The ability to assess, interpret, and report the results of exercise tests for individuals with medical conditions, including identification of contraindications, and the use of clinical functional tests, ECG, gas analysis, strength, aerobic capacity, and body composition evaluation.
Evidence:
Demonstrates the ability to take a case history and evaluate which exercise protocol will safely and effectively measure aerobic capacity, strength, and give information needed for exercise prescription.
Demonstrates the ability to identify client/patient requirements, target deficient areas including strength, aerobic capacity, balance and flexibility, implement appropriate tests, and document findings.
Demonstrates the ability to identify when clinical evaluations such as ECG, expired gas analysis or body composition evaluations are warranted.
Demonstrates the ability to conduct a case study analysis where the applicant can recommend appropriate testing protocols and give a rationale for their inclusion.
Demonstrates the ability to conduct all exercise testing protocols and the ability to implement them on varying population groups with accurate and complete documentation.
Demonstrates the ability to recognize abnormal test results or signs and symptoms inconsistent with the client/patient’s expected health status, and refer the client/patient for medical assessment or call emergency medical services if appropriate.
1.4 An understanding of exercise prescription modification for clinical populations; the relationship between oxygen cost, biomechanical efficiency, and performance; and the muscular, cardiorespiratory, and metabolic effects of deconditioning.
Evidence:
The ability to identify limiting factors and modify exercise prescriptions to accommodate all stages and aspects of exercise training.
Be able to conduct a specific case study analysis where the applicant recommends appropriate prescription modification based on a client/patient's requirements.
Demonstrates knowledge of common impairments of function, due to disease, aging or deconditioning and basic exercises that improve functional capacity in biomechanical efficiency, muscular, cardiorespiratory or metabolic effects.
1.5 Knowledge and ability to appropriately modify exercise prescription for clinical populations including the elderly, and to provide an appropriate level of supervision, safety, outcomes monitoring, and evaluation.
Evidence:
Demonstrates knowledge of exercise prescription for the elderly including safety, supervision and outcomes monitoring.
The ability to use information from an initial fitness testing session to prescribe safe and effective exercise for a wide range of clinical populations.
The ability to provide an appropriate level of supervision and schedule client/patients for follow-up testing that can evaluate whether or not a programme was effective at advancing targeted functional gains.
1.6 Knowledge of health behaviour of clinical populations, its evaluation, and modification with counselling.
Evidence:
Demonstrates knowledge of behaviour change in healthy client/patients as well as those with a significant mental or physical abnormality or disease process, and when the need for counselling is outside the Clinical Exercise Physiologist’s scope of practice.
The ability to encourage a client/patient’s adoption of healthy behaviour regarding a wide range of areas, including, but not limited to mitigate destructive self-talk, poor self-confidence, high anxiety, poor nutrition, and high stress levels.
The ability to make clinical referrals to appropriate health professionals.
The ability to analyse given information (physical or mental limitations, the client/patient’s personality and level/stage of change), and determine what types of information would be most helpful to them in adoption of targeted health behaviour modification.
1.7 Must hold a current Level 3 First Aid certificate, or higher (or equivalent certification) at all times, as per CEPNZ requirements. Knowledge and ability to implement emergency procedures, their evaluation and administration, staff training, and the maintenance of emergency equipment including AEDs.
Evidence:
Holds a current certificate and demonstrates knowledge of written emergency procedures and their dissemination.
Demonstrates basic life support procedures, including first aid, CPR and the use of AEDs.
1.8 Knowledge of the Clinical Exercise Physiologist’s Scope of practice, reporting, legal issues, and quality assurance.
Evidence:
Be able to give examples of the implications to the client/patient and to the practitioner of working outside of the Scope of Practice.
Demonstrates knowledge of the legal implications of documented safety procedures, incident documentation, treatment notes, ongoing safety training, the legal implications of privacy protection, and data storage.
Provide written documentation outlining clinic procedures and the practitioner’s understanding of their implementation and importance.
1.9 Research-related skills for accessing and evaluating research evidence.
Evidence:
Demonstrates an understanding of the need for evidence-based practice (the process of using scientific evidence to inform decision making and professional practice).
Demonstrates knowledge in searching for scientific literature, acquiring evidence from credible source and differentiating the strength of evidence from available sources.
1.10 Knowledge of the Treaty of Waitangi, cultural competence and safety as it relates to the Clinical Exercise Physiologist’s Scope of practice.
New Zealand society includes a large number of ethnicities, cultures and belief systems. It is important that the Registered Clinical Exercise Physiologist has the ability to work with individuals (e.g., other health professionals or client/patients) across a range of social and cultural backgrounds and beliefs. A key requirement of the New Zealand Health system is to improve the health of Māori and to reduce health disparities for Māori. It is recognised that the Registered Clinical Exercise Physiologist, alongside or in partnership other health professionals, will play a role in improving the health of Māori from clinical exercise physiology service provision.
As a core requirement for Clinical Exercise Physiologists practicing in New Zealand, it is essential to have an understanding of the Treaty of Waitangi (and the rights of tangata whenua and obligations of the Crown related to the Treaty), have an understanding of Māori Health (including models of health, Te Whare Tapa Wha, and the Whanau Ora framework) and have an awareness of cultural safety requirements for cultural competence. A core understanding of these aspects will support the provision of services in a culturally safe way, by a culturally competent health professional, and will enable the Registered Clinical Exercise Physiologist to work effectively with Māori client/patients and Māori health providers
Evidence:
Demonstrates a working knowledge of cultural safety.
Is able to analyse their own practice procedures and implement cultural safety measures.
2. CARDIAC
2.1 Understanding of the pathophysiology, epidemiology, risk factors, and treatment options including common cardiac medications related to hypertension, myocardial infarction, revascularization procedures, angina, atrial fibrillation and other arrhythmias, pacemakers, valvular heart disease, aneurysms, chronic heart failure, heart transplant, and peripheral artery disease.
Evidence:
Demonstrates a working knowledge of the scope of cardiovascular diseases, including risk factors, pathophysiology and current treatment options.
Demonstrates knowledge of cardio-pulmonary physiology and the pathophysiology of all types of CVD.
Demonstrates knowledge of cardiovascular medications and their effects on cardiovascular function at rest and during exercise.
An ability to access and evaluate new and existing research regarding cardiac diseases.
2.2 An understanding of cardiovascular disease diagnosis including exercise testing, contraindications to exercise testing and exercise training, and signs and symptoms of exercise intolerance.
Evidence:
Demonstrates knowledge of cardiovascular diagnostic procedures, and the risk factors or conditions that may require consultation with medical personnel before exercise testing or exercise training.
An ability to screen and monitor client/patients before and during exercise with an understanding of how to manage abnormal exercise responses.
Demonstrates knowledge of the effects of cardiovascular disease on cardiorespiratory responses at rest and during exercise.
An ability to examine, detect, and manage abnormal changes in heart rate, blood pressure, angina, syncope, or claudication during exercise testing or programme implementation and the ability to modify exercise prescription accordingly.
An ability to recognize abnormal ECG responses and take appropriate steps to adjust or terminate an exercise programme and/or refer appropriately.
Knowledge of absolute and relative contraindications for exercise testing and training.
2.3 An understanding of medical and surgical treatments, practice guidelines, and preventive care.
Evidence:
An ability to explain to the client/patient the common medical and surgical treatments for cardiovascular disease, including commonly used medications, clinical practice guidelines, and preventive care as well as how exercise will affect disease progression and prognosis.
Evidence of ability to explain how the side effects and drug actions of medications will/may manifest during exercise.
2.4 An understanding of the benefits of effects of exercise in cardiovascular disease prevention and rehabilitation and signs and symptoms of exercise intolerance in cardiac patients.
Evidence:
Identification and use of symptom limits during exercise.
Demonstrates knowledge of the effects of cardiovascular disease on cardiorespiratory responses at rest and during exercise, and how it will affect the client/patients exercise prescription.
Demonstrates knowledge of the chronic and acute effects and benefits of exercise for cardiovascular disease.
An ability to design, adapt, communicate and supervise a safe and effective exercise prescription for individuals with cardiovascular disease.
An ability to counsel individuals on warning signs and symptoms and both the need and the proper use of nitroglycerin treatment.
Knowledge of angina treatment including identification (with and without an ECG) of silent angina in diabetic patients.
2.5 An understanding of the comorbidities commonly associated with cardiovascular disease.
Evidence:
Demonstrates knowledge of co-morbidities associated with cardiovascular disease.
Demonstrates knowledge of, and the effects of comorbidities, and how exercise testing and exercise prescription are modified for cardiac patients to ensure an exercise programme is safe, effective and achievable.
3. PULMONARY
3.1 An understanding of the pathophysiology, epidemiology, risk factors and their reduction, and the key clinical findings related to chronic obstructive pulmonary disease, asthma, emphysema, bronchitis, and cystic fibrosis.
Evidence:
Demonstrates a working knowledge of the scope of pulmonary diseases, from their risk factors, inception, progression, and treatment as well as ways in which this process can be modified.
An ability to access and evaluate new and existing research regarding pulmonary diseases.
3.2 An understanding of how pulmonary disease is diagnosed, the physical examination and its limitations including exercise testing, contraindications to exercise, and how to respond to abnormal signs and symptoms.
Evidence:
Demonstrates knowledge of pulmonary diagnostic procedures, and the risk factors and signs and symptoms that may require consultation with medical personnel before testing or training.
Demonstrates knowledge of the effects of pulmonary disease at rest and during exercise.
An ability to examine, detect, and manage inappropriate changes in HR, BP, O2 saturation, dyspnoea, or syncope during exercise testing or programme implementation and the ability to modify exercise prescription accordingly.
Knowledge of the absolute and relative contraindications to lung related disease and how to identify them.
3.3 An understanding of the medical and surgical treatments, practice guidelines, preventive care, drug actions and side effects especially during exercise.
Evidence:
Demonstrates knowledge of cardio-pulmonary physiology and the pathophysiology of common types of obstructive and restrictive pulmonary disease.
An ability to explain to the client/patient the common medical and surgical treatments for lung disease, including commonly used medications, clinical practice guidelines, and preventive care as well as how exercise will affect the progression/outcome of their disease.
An ability to understand the airway management plan that the client/patient might receive at a typical respiratory clinic and its implications during exercise.
Demonstrates ability to educate client/patients on importance of home life and effects on this condition (dehumidification, smoking, etc.)
3.4 An understanding of the effects of exercise, exercise prescription, and safety instructions.
Evidence:
Demonstrates knowledge of the effects of pulmonary disease on cardiorespiratory responses at rest and during exercise, and how it will affect the client/patient’s exercise prescription.
Demonstrates knowledge of the chronic and acute effects and benefits of exercise for pulmonary disease.
An ability to identify and use symptom limits as part of the prescription process.
An ability to design, adapt, communicate and supervise a safe and effective exercise prescription for individuals with pulmonary disease.
An ability to counsel individuals on warning signs and symptoms and both the need to use appropriate medication as part of his/her airway management plan.
3.5 An understanding of the exercise prescription, supervision, safety instructions, and an ability to use supplemental oxygen.
Evidence:
Demonstrates adequate understanding of oxygen saturation cut-off levels as it relates to exercise testing and training.
Demonstrates knowledge of the effects of pulmonary disease on exercise, and how it will affect the client/patient’s exercise prescription.
An ability to design, adapt, communicate and supervise a safe and effective exercise prescription for individuals with pulmonary disease.
An ability to counsel individuals on warning signs and symptoms that may occur during exercise.
An ability to know when and how to apply supplementary oxygen as part of early in-hospital exercise mobilization rehabilitation.
3.6 An understanding of the comorbidities commonly associated with pulmonary disease.
Evidence:
An ability to list possible co-morbidities.
Demonstrates knowledge of, and the effects of, common comorbidities and how exercise prescription is modified to ensure an exercise programme is achievable, safe, and effective.
4. METABOLIC
4.1 An understanding of the pathophysiology, epidemiology, risk factors, and the key clinical findings for obesity, chronic renal and liver disease, hyperlipidaemia, dyslipidaemia, poor glucose control consequences, diabetes, gestational diabetes, and peripheral arterial disease.
Evidence:
Demonstrates a working knowledge of metabolic syndrome and diabetes, including the risk factors, prevention, progression, and treatment as well as ways in which this process can be modified.
Demonstrates an ability to identify key components of diseases associated with metabolic syndrome; including an understanding of their aetiology/pathophysiology.
An ability to access and evaluate new and existing research regarding metabolic syndrome and renal failure.
4.2 An understanding of how metabolic syndrome and renal failure are diagnosed, physical examination and its limitations including exercise testing, contraindications to exercise, and responding to abnormal signs and symptoms.
Evidence:
Demonstrates knowledge of absolute and relative contraindications e.g., glucose and ketone cut offs.
Demonstrates knowledge of metabolic syndrome and renal failure, and the risk and signs and symptoms that may require consultation with medical personnel before testing or training.
Demonstrates knowledge of the effects of metabolic syndrome and renal failure on cardiorespiratory responses at rest and during exercise.
An ability to examine, detect, and manage inappropriate changes in vital signs during exercise testing or programme implementation and the ability to modify exercise prescription accordingly.
Demonstrates a knowledge and can verbally explain glucose control – its relevance and importance.
4.3 An understanding of the medical and surgical treatments, practice guidelines, preventive care, drug actions and side effects especially during exercise.
Evidence:
Demonstrates an ability to educate client/patients on how to navigate diet, exercise and insulin to create a stable glucose response.
Demonstrates knowledge of medical management of metabolic syndrome and renal failure.
An ability to explain to the client/patient the common medical and surgical treatments for metabolic syndrome and renal failure, including commonly used medications, clinical practice guidelines, and preventive care as well as how exercise will affect the progression/outcome of their disease.
Demonstrates knowledge on how to effectively manage hypo- or hyper-glycaemic situations.
4.4 An understanding of the effects of exercise, exercise prescription, safety instructions.
Evidence:
Demonstrates knowledge on how to check for silent angina and understands why this may be an issue with diabetic client/patients.
Demonstrates knowledge of testing blood glucose pre- and post-exercise testing and training and its importance.
Demonstrates knowledge of the effects of metabolic syndrome and renal failure on cardiorespiratory responses at rest and during exercise, and how it will affect the client/patients exercise prescription.
Demonstrates knowledge of the chronic and acute effects and benefits of exercise for metabolic syndrome and renal failure.
An ability to design, adapt, communicate and supervise a safe and effective exercise prescription for individuals with metabolic syndrome and renal failure.
An ability to counsel individuals on warning signs and symptoms.
4.5 An understanding of the comorbidities commonly associated with metabolic syndrome and renal failure.
Evidence:
Can list comorbidities.
Demonstrates knowledge of, and the effects of, the list of comorbidities and how exercise prescription is modified to ensure an exercise programme is achievable, safe, and effective.
5. MUSCULOSKELETAL & ORTHOPAEDIC
5.1 An understanding of the epidemiology, pathophysiology, risk factors, and key clinical findings of orthopaedic conditions including; osteoporosis, joint injury, pre- and post-surgery, amputees, chronic back and neck pain, the common forms of arthritis, fibromyalgia, and chronic fatigue syndrome.
Evidence:
Demonstrates a working knowledge of musculoskeletal and orthopaedic disorders, including the risk factors, prevention, progression, and treatment as well as ways in which this process can be modified.
An ability to access and evaluate new and existing research regarding metabolic syndrome and musculoskeletal and orthopaedic disorders.
5.2 An understanding of how musculoskeletal and orthopaedic disorders are diagnosed, physical examination and its limitations including exercise testing, contraindications to exercise, and responding to abnormal signs and symptoms.
Evidence:
An ability to conduct a musculoskeletal assessment using injury history, observation, palpation, range of movement, special tests and posture analysis.
Demonstrates knowledge of musculoskeletal and orthopaedic disorders, and the risk factors and signs and symptoms that may require consultation with medical personnel before testing or training.
Demonstrates an ability to assess movement patterns as part of musculoskeletal rehabilitation, identify exercises that could worsen the condition, and how to correct abnormal movement patterns with exercise.
Demonstrates knowledge of the effects of musculoskeletal and orthopaedic disorders on cardiorespiratory responses at rest and during exercise.
Ability to assess the major joints for stability and functionality using ROM and special tests.
An ability to examine, detect, and manage inappropriate changes in vital signs and reported pain during exercise testing or programme implementation and the ability to modify exercise prescription accordingly.
5.3 An understanding of the medical and surgical treatments, practice guidelines, preventive care, drug actions and side effects especially during exercise.
Evidence:
Demonstrates knowledge of medical management of musculoskeletal and orthopaedic disorders.
An ability to explain to the client/patient the common medical and surgical treatments for musculoskeletal and orthopaedic disorders, including commonly used medications, clinical practice guidelines, and preventive care as well as how exercise will affect the progression/outcome of their disease.
5.4 An understanding of the effects of exercise, exercise prescription, safety instructions.
Evidence:
Demonstrates knowledge of the effects of musculoskeletal and orthopaedic disorders on cardiorespiratory responses at rest and during exercise, and how it will affect the client/patients exercise prescription.
Demonstrates knowledge of the chronic and acute effects and benefits of exercise for musculoskeletal and orthopaedic disorders.
An ability to design effective exercise prescription for individuals with musculoskeletal and orthopaedic disorders.
Ability to counsel individuals on warning signs and symptoms.
5.5 An understanding of exercise prescription, work and sport specific, occupational rehabilitation, supervision, safety instructions, and post-surgery modifications.
Evidence:
Demonstrates knowledge and ability to work with physiotherapists and occupational therapists, and refer to other health professionals appropriately.
Demonstrates knowledge of planning and implementing exercise programmes to meet the client/patients goal of returning to work.
An ability to identify principal biomechanical stresses related to the client/patient’s job, provide an appropriate exercise programme, and set realistic goals.
An ability to modify exercise programmes to accommodate post-surgical structural and functional vulnerability.
5.6 An understanding of the comorbidities commonly associated with musculoskeletal and orthopaedic disorders.
Evidence:
Demonstrates and can list the common causes and stages of musculoskeletal injuries.
Demonstrates knowledge of the causes and the effects of the common comorbidities and how exercise prescription is modified to ensure an exercise programme is achievable, safe, and effective
6. NEUROLOGICAL & NEUROMUSCULAR
6.1 An understanding of the pathophysiology, epidemiology, risk factors, and key clinical findings of Alzheimer’s disease, Parkinson’s disease, stroke, traumatic brain injury, spinal cord injury, cerebral palsy, muscular dystrophy, and multiple sclerosis.
Evidence:
Demonstrates a working knowledge of neurological and neuromuscular disorders, including the risk factors, prevention, progression, and treatment as well as ways in which this process can be modified.
An ability to access and evaluate new and existing research regarding neurological and neuromuscular disorders.
6.2 An understanding of how neurological and neuromuscular disorders are diagnosed, physical examination and its limitations including exercise testing, contraindications to exercise, and responding to abnormal signs and symptoms.
Evidence:
Demonstrates knowledge of neurological and neuromuscular disorders, and the risk factors and signs and symptoms that may require consultation with medical personnel before testing or training.
Demonstrates knowledge of the effects of neurological and neuromuscular disorders on cardiorespiratory responses at rest and during exercise.
An ability to examine, detect, and manage inappropriate changes in vital signs and reported pain during exercise testing or programme implementation and the ability to modify exercise prescription accordingly.
Ability to examine and apply functional and range of motion tests along with postural assessments to prescribe appropriate exercise.
6.3 An understanding of the medical and surgical treatments, practice guidelines, preventive care, drug actions and side effects especially during exercise.
Evidence:
Demonstrates knowledge of medical management of neurological and neuromuscular disorders.
An ability to explain to the client/patient the common medical and surgical treatments for neurological and neuromuscular disorders, including commonly used medications, clinical practice guidelines, and preventive care as well as how exercise will affect the progression/outcome of their disease.
6.4 An understanding of the effects of exercise, exercise prescription, safety instructions.
Evidence:
Ability to adapt the exercise prescription based on functional limits and benefits of assistive devices (wheelchairs, crutches or canes).
Demonstrates knowledge of the effects of neurological and neuromuscular disorders on cardiorespiratory responses at rest and during exercise, and how it will affect the client/patients exercise prescription.
Demonstrates knowledge of the chronic and acute effects and benefits of exercise for neurological and neuromuscular disorders.
An ability to design, adapt, communicate, instruct and supervise a safe and effective exercise prescription for individuals with neurological and neuromuscular disorders.
An ability to counsel individuals on warning signs and symptoms.
An ability to conduct movement analysis and prescribe/adjust rehabilitation exercise to correct abnormal movement patterns.
6.5 An understanding of the comorbidities commonly associated with neurological and neuromuscular disorders.
Evidence:
An ability to list commonly associated co-morbidities.
Demonstrates knowledge of, and the effects of comorbidities and how exercise prescription is modified to ensure an exercise programme is achievable, safe, and effective.
7. CANCER
7.1 An understanding of the pathophysiology, epidemiology, risk factors, and key clinical findings of neoplastic disease and post-oncology clinical findings, especially breast, colorectal, and prostate cancer.
Evidence:
Demonstrates a working knowledge of the development of cancer, types of cancer and effects of chemotherapy and surgery on exercise testing and prescription.
Demonstrates knowledge of the risk factors, prevention, progression, and treatment as well as ways in which this process can be modified.
An ability to access and evaluate new and existing research regarding neoplastic disease.
7.2 An understanding of how neoplastic disease is diagnosed, physical examination and its limitations including exercise testing, contraindications to exercise, and responding to abnormal signs and symptoms.
Evidence:
Demonstrates knowledge of neoplastic disease, and the risk factors and signs and symptoms that may require consultation with medical personnel before testing or training.
Demonstrates knowledge of the effects of neoplastic disease on cardiorespiratory responses at rest and during exercise.
An ability to examine, detect, and manage inappropriate changes in vital signs and reported pain during exercise testing or programme implementation and the ability to modify exercise prescription accordingly.
7.3 An understanding of the medical and surgical treatments, practice guidelines, preventive care, drug actions and side effects especially during exercise.
Evidence:
Demonstrates knowledge of medical management of neoplastic disease.
An ability to explain to the client/patient the common medical and surgical treatments for neoplastic diseases, including commonly used medications, clinical practice guidelines, and preventive care as well as how exercise will affect the progression/outcome of their disease.
7.4 An understanding of the effects of exercise, exercise prescription, safety instructions.
Evidence:
Describes the immediate and long-term influence of medical therapies on neoplastic diseases and their responses to aerobic, resistance and flexibility training.
Demonstrates knowledge of the effects of cancer and its treatment on cardiorespiratory responses at rest and during exercise, and how it will affect the client/patient’s exercise prescription.
Demonstrates knowledge of the chronic and acute effects and benefits of exercise for neoplastic diseases.
An ability to design, adapt, communicate and supervise a safe and effective exercise prescription for individuals with neoplastic diseases.
An ability to counsel individuals on warning signs and symptoms.
Describes the potential benefits and hazards of aerobic, resistance and flexibility training in individuals with cancer.
Understands the contraindication to vigorous exercise in cancer patients
Understands the risks and precautions for exercise in cancer patients.
7.5 An understanding of the comorbidities commonly associated with neoplastic diseases.
Evidence:
Demonstrates knowledge of, and the effects of, comorbidities and how exercise prescription is modified to ensure an exercise programme is achievable, safe, and effective.
8. IMMUNE & HAEMATOLOGICAL DISORDERS (IHDs)
8.1 An understanding of the pathophysiology, epidemiology, risk factors, and key clinical findings of human immunodeficiency syndromes, the anaemias, leukaemia, lymphoma, disorders of the coagulation system.
Evidence:
Demonstrates a working knowledge of immune and haematological disorders, including the risk factors, prevention, progression, and treatment as well as ways in which this process can be modified.
An ability to access and evaluate new and existing research regarding immune and haematological disorders.
8.2 An understanding of how immune and haematological disorders are diagnosed, physical examination and its limitations including exercise testing, contraindications to exercise, and responding to abnormal signs and symptoms.
Evidence:
Demonstrates knowledge of immune and haematological disorders, and the risk factors and signs and symptoms that may require consultation with medical personnel before testing or training.
Demonstrates knowledge of the effects of immune and haematological disorders on cardiorespiratory responses at rest and during exercise.
An ability to examine, detect, and manage inappropriate changes in vital signs and reported pain during exercise testing or programme implementation and the ability to modify exercise prescription accordingly.
Describes the immediate and long-term influence of medical therapies on IHDs and the responses of aerobic, resistance and flexibility training.
8.3 An understanding of the medical and surgical treatments, practice guidelines, preventive care, drug actions and side effects especially during exercise.
Evidence:
Demonstrates knowledge of medical management of immune and haematological disorders.
An ability to explain to the client/patient the common medical and surgical treatments for immune and haematological disorders, including commonly used medications, clinical practice guidelines, and preventive care as well as how exercise will affect the progression/outcome of their disease.
Describes the potential hazards of aerobic and resistance training in individuals with IHDs.
8.4 An understanding of the effects of exercise, exercise prescription, safety instructions.
Evidence:
Demonstrates knowledge of the effects of immune and haematological disorders on cardiorespiratory responses at rest and during exercise, and how it will affect the client/patient’s exercise prescription.
Demonstrates knowledge of the chronic and acute effects and benefits of exercise for immune and haematological disorders.
An ability to design, adapt, communicate and supervise a safe and effective exercise prescription for individuals with immune and haematological disorders.
An ability to counsel individuals on warning signs and symptoms.
8.5 An understanding of the comorbidities commonly associated with immune and haematological disorders.
Evidence:
Lists commonly associated comorbidities.
Demonstrates knowledge of, and the effects of, from the list of comorbidities and how exercise prescription is modified to ensure an exercise programme is achievable, safe, and effective.
9. PSYCHOLOGICAL & MOOD
9.1 An understanding of the pathophysiology, epidemiology, risk factors, and key clinical findings of common psychological and mood disorders especially depression, anxiety, autism spectrum disorder, Asperger’s syndrome, and attention deficit disorder.
Evidence:
Demonstrates a working knowledge of psychological and mood disorders, including the risk factors, prevention, progression, and treatment as well as ways in which this process can be modified.
An ability to access and evaluate new and existing research regarding psychological and mood disorders.
9.2 An understanding of how psychological and mood disorders are diagnosed, physical examination and its limitations including exercise testing, contraindications to exercise, and responding to abnormal signs and symptoms.
Evidence:
Demonstrates knowledge of psychological and mood disorders, and the risk factors and signs and symptoms that may require consultation with medical personnel before testing or training.
Demonstrates knowledge of the effects of psychological and mood disorders on cardiorespiratory responses at rest and during exercise.
An ability to examine, detect, and manage inappropriate changes in vital signs and reported pain during exercise testing or programme implementation and the ability to modify exercise prescription accordingly.
9.3 An understanding of the medical treatments, practice guidelines, preventive care, drug actions and side effects especially during exercise.
Evidence:
Demonstrates knowledge of medical management of psychological and mood disorders.
An ability to explain to the client/patient the common medical treatments for psychological and mood disorders, including commonly used medications, clinical practice guidelines, and preventive care as well as how exercise will affect the progression/outcome of their disease.
Demonstrates an understanding of how prescription medicine affects exercise tolerance.
9.4 An understanding of the effects of exercise, exercise prescription, and safety instructions.
Evidence:
Demonstrates knowledge of the effects of psychological and mood disorders on cardiorespiratory responses at rest and during exercise, and how it will affect the client/patient’s exercise prescription.
Demonstrates knowledge of the chronic and acute effects and benefits of exercise for psychological and mood disorders.
An ability to design, adapt, communicate and supervise a safe and effective exercise prescription for individuals with psychological and mood disorders.
An ability to counsel individuals on warning signs and symptoms.
9.5 An understanding of the comorbidities commonly associated with psychological and mood disorders.
Evidence:
Demonstrates knowledge of, and the effects of, comorbidities and how exercise prescription is modified to ensure an exercise programme is achievable, safe, and effective.
Demonstrates an understanding of how psychological disorders could be associated with clustering of risk factors.
9.6 An understanding of clinician-client/patient communications, social and cultural pressures.
Evidence:
Awareness of communication and other cognitive and social pressures that could be affected by mental health disorders; and ability of the client/patient to make lifestyle changes.
An ability to modify communication strategies to improve effectiveness.
An understanding of how group/peer/culture/socio-economic status/society can affect diet, thinking patterns and coping and how this could contribute to psychological disorders.
Demonstrates knowledge of the impact of culture and society and why some chronic diseases and obesity may be an ecological issue as well as an individual issue.