The benefits of exercise are well known, but these become additionally important for people recovering from medical events or chronic conditions. Exercise can provide benefit in prevention, rehabilitation and recovery for a variety of health conditions for the general public as well as those with high risk factors. For the team at the Human Potential Clinic, their aim is to prescribe an exercise workload which is best suited to each individual, ideally before they encounter any health issues.
But there’s more to it than simply going for the occasional walk following a hospital stay. The field of clinical exercise physiology, where medical monitoring is used to design a programme specific to someone’s health and capacity, is well established overseas, with many governments funding it at a central level. Here in New Zealand, the field is slowly growing, but relies on medical practitioners encouraging their patients to undertake specialised services, or people doing their own research. “It really depends on each district health board,” says Human Potential Clinic Manager Matt Wood of the availability of services. “Some DHBs run a rehabilitation programme for different conditions, and for others, they don’t have anything in place.” That’s where the Human Potential Clinic comes in, improving the wellbeing and management of patients at various stages of health.
When dealing with medical conditions, it is important to get exercise workload just right. Too little, and patients won’t notice a difference and lose enthusiasm. Too much, and there may be adverse effects which discourage people from exercising at all. By medically assessing a person while exercising on a bike or treadmill, the team is able to measure how that person’s body functions under exercise stress, and individualise a programme which adheres to their capabilities and limits. “Throughout the assessment, we monitor blood pressure under variable intensity, how many breaths they take, their oxygen use and carbon dioxide production,” tells Matt Stratton, one of the Clinic’s exercise physiologists. “From there, we can find the threshold points of where someone should be training, what’s going to be safe and most effective for them.”
The typical length of a programme with the Clinic is 12 weeks, allowing time for the client to adjust to the exercise regime and become comfortable with self-management. “Most of the time, we’re designing programmes which are less than an hour long,” says Wood, “and we incorporate all the cardio and resistance exercises to ensure clients are getting the most out of each session. We taper down our supervision as they continue to improve, and they begin to understand how the exercise is making a difference.” Clients are free to return to the Clinic for advancements when they feel they’ve progressed sufficiently, and the team are always available for support, empowerment and education.
“Sometimes people get us confused with personal trainers,” Wood says. “Our qualifications and expertise are completely different from trainers, and so are our goals. We work closely with a client for a period of time with the aim of them moving into healthy self-management.” Depending on the individual, that can be anything from mobilisation to a complete return to work. The programme is supplemented by education and support all geared towards independence. Stratton shares one of his favourite outcomes of a client with uncontrolled diabetes. “He had a quadruple bypass, had altered sensation throughout all of his limbs, and no tolerance to changes in his blood sugars,” he recalls. “He changed his whole lifestyle, his diet and exercise, and he made a lot of little changes which had a major impact. It was really rewarding to see.”
While some measures such as Body Mass Index are widely used in health and medical contexts, research has proven that the strongest marker for health conditions is cardiovascular fitness. “It is the same marker as used in sports performance, but we use it in a totally different way,” says Wood. “Whereas elite athletes are looking for small performance increases, we’re able to use the same markers and see a lot of prognostic information, particularly for cardiovascular disease, which accounts for approximately 30% of all deaths in New Zealand each year.”
Most exercise physiology research has been established overseas, where bigger populations can enable larger sample sizes, however the Clinic has worked with local research partners to investigate the therapeutic effects of exercise for cancer patients. For some cancers, patients who exercise can experience less side effects from their treatment, less reoccurrences and an improvement in their quality of life. For cancers such as colorectal and breast, exercise can see up to a 40% reduction in relative risk of mortality. “We want to educate people about these benefits, and that they are proven by research,” Wood says. “So it is a matter of informing frontline medical professionals about what we do and what’s possible.”
The team work with local gyms, including staff at AUT Millennium, and medical professionals to explain and promote best practice. Most gyms do ask new members about their medical conditions, but they are unlikely to actively monitor a person while they work out. As with nurses and GPs, if they are aware of exercise physiology and its benefits, they can refer a person to a physiologist to ensure they undertake safe and effective exercise programmes. “Until people see what we do, they don’t really ‘get’ it,” says Stratton. “But we form an important part of a multi-disciplinary team helping this person get healthier, which is what the medical and fitness industries want.”
The biggest challenge for the team is spreading the word about their services and the benefits to the general public, those who aren’t suffering from chronic conditions. They don’t want to be the ambulance at the bottom of the cliff. “The benefits of individualisation are huge. You can make meaningful change without too much effort,” Stratton says. “You will get so much more out of something tailored to you, rather than something generic. Exercise prescription is for everyone, and everyone will see change – safely.”
What can exercise physiology help with?
- Cardiovascular disease and risk factors
- During and after cancer treatment
- Anxiety and depression
- Frailty in older adults
- Joint health
If you would like to know more about how the Human Potential Clinic could help you, contact the team on 09 921 9999 ext 7848, or visit their website.