I currently work in a primary care office that doubles as wellness clinic for a geriatric population. My lead physician created the space as an area where the older population who wouldn’t go to a normal commercial gym would have an area to workout and improve their health. The big slogan behind it is “Movement is Medicine”. However, walking into it there is only a handful of personal trainers, who I am working to get certified as I am now the Lead Exercise Physiologist in the clinic. If any of you (moderators) who have been around the space for while, what testing would you like to see conducted in this time of space?
We currently do exercise tolerance testing with the use of a Bruce Testing protocol. I am working on getting them to order an InBody scanner for BIA to assess composition and look further into other measurements as I believe at this time the DEXA scanner wouldn’t be as cost effective. I will also be using it to make different recommendations for nutritional and exercise prescription, and if needed refer out to a dietician for issues outside of my scope.
Please let me know your thoughts, thank you.
Howdy.
Thanks for the post. Sounds like a potentially cool gig, for sure.
For me, I am not sure I am particularly interested in testing of any kind in this population. In other words, I don’t think a stress test or similar is useful for exercise prescription or monitoring exercise response, though it is certainly can be useful for clearing individuals for exercise. Same thing with InBody…it’s not precise enough to measure individual changes over time and it doesn’t change management, e.g. I’m not sure it should be used to make different recommendations for nutrition and training.
I think the most useful data would be centered around the following:
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Differences in attitudes, values, beliefs, etc. in individuals coming to this clinic vs matched controls who don’t. Same thing with high responders vs “non” responders, those with high adherence vs low adherence, etc.
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Correlations between longitudinal changes in strength, power, muscle mass, and cardiorespiratory fitness and various health metrics, e.g. resting BP, fasting plasma glucose, timed up and go, etc.
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Comparative analysis of strategies that worked for recruiting patients
That sort of stuff would be interesting to me.
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Jordan,
Thank you sir for the response it is greatly appreciated. It is something I am looking at while here at the clinic. The stress testing is more for clearing individuals for exercise but also looking at possible ischemic heart disease as well. As for the InBody, it was just an idea I brought to them to see if it was something they would be okay with as, like you said it isn’t the most precise, however it does get the estimate of BMI and/or BMR depending upon the model which we can use to help create that behavior change for our patients who need help adhering to either exercise or diet habits.
I will also definitely look into the other data points you mentioned. For me it will just being able to get the metrics and quantify that into something useful to show how the program is advantageous. For the couple I work with personally, I have started looking into their various health metrics and hopefully will be able to start getting some data off of them.
Yea, most people do not need a stress test for clearance from exercise or to be evaluated for ischemic heart disease prior to exercise. InBody does not generate an accurate BMR either, nor is this information particularly useful for management. In other words, knowing someone’s BMR accurately, which InBody does not provide, does not influence dietary recommendations.
Longitudinal changes in important outcomes like strength, cardiorespiratory fitness, etc. would be very helpful at demonstrating efficacy IMO.
I greatly appreciate your help and input, hopefully I am able to get the program here moving in a good direction. I just have not worked in this setting before trying to do all of this so I am trying my best to piece some things together to improve the outcome and make something sustainable long term to be used at the clinic.