As obesity in the United States continues to increase at alarming rates, the shift of focus towards preventative medicine through health and wellness is becoming more apparent. According to the Centers for Disease Control and Prevention (CDC), more than one-third (or 78.6 million of U.S. adults are obese). In 2012 CDC also indicated that more than one-third of U.S. children and adolescents were overweight or obese.
As alarming as these numbers may appear, an even greater concern is obesity in the disabled population. With compromised mobility and function being a greater challenge than with an abled-body individual, caloric expenditure is more difficult for the disabled population. Disabled individuals’ limited ability to actively use calories results in approximately 56 million Americans with disabilities facing a much greater risk of developing obesity. They face possible development of serious health problems associated with a sedentary lifestyle. The Inclusive Fitness Coalition states, “the high incidence of secondary conditions reported among people with disabilities including obesity, fatigue, pain, deconditioning and depression, combined with environmental barriers that discourage participation in community exercise programs, presents an opportunity for health professionals to target people with disabilities in their long-term plans.”
Physical activity can provide individuals with disabilities the strength and stamina required to participate in all aspects of life actively and successfully. Most disabled individuals require physical activity once formal physical therapy has been completed. They must implement an active physical regimen in order to maintain the advances that they have made in physical therapy. They must also be physically active to improve and maintain their health and to prevent hospital re-admissions. Many healthcare professionals recommend personal trainers as a remedy for this requirement. Although personal trainers are fitness professionals who withhold the knowledge, skills and abilities to create safe and effective exercise programs to reach personal health and wellness goals, their work is predominantly with the healthy, abled-body population. Few have the experience and/or the skills to develop and provide the needed programing for disabled individuals.
The National Academy of Sports Medicine states, “personal trainers are health and fitness professionals who perform individualized assessments, and design safe, effective and individualized exercise and conditioning programs which are scientifically valid and based on clinical evidence to clients with no medical or special needs”.
The World Instructor Training School (WITS) says, “certified personal trainers do not diagnose and/or treat areas of pain or disease and will refer clients to other health professionals/practitioners when appropriate.”
Finally, the American College of Sports Medicine (ACSM) proclaims, “the ACSM Certified Personal Trainer (CPT) is qualified to plan and implement exercise programs for healthy individuals or those who have medical clearance to exercise.”
With a few top respected personal training institutions in the industry declaring that the scope of practice for personal trainers does not include the disabled community, what other option exists for the disabled population and the medical professionals who help them? A Functional Exercise Specialist (FES) is the answer. A functional exercise program is defined as, “a specialized program for disabled, injured, or chronically ill individuals, consisting of physical exercises designed for specific goals and outcomes that promote total body health & wellness, which progress the individual to a greater level of independence.”
A FES and a Personal Trainer are often mistaken for the same professional, even though the two titles are different in philosophy and purpose. A FES fills the void between a Physical Therapist and Personal Trainer, as the focus is working strictly with special needs populations (i.e. traumatic brain injuries, spinal cord injuries, amputations, stroke, etc.). The below criteria must be met by an FES before he/she is able to work independently and dedicate himself/herself to working solely with people with physical and/or cognitive disabilities.
1. At least a Bachelor’s degree in an exercise science or health related field
2. Specialized certifications geared towards working directly with the disabled community
3. No less than 100 hours of classroom and hands-on training with disabled individuals
A FES offers medical professionals an additional resource to which they can refer their patients after they have been discharged from, or even in conjunction with physical therapy. A FES assists the patient to gradually acclimate back to a community setting, as well as help to bridge the gap between physical therapy and a home exercise program (HEP); which unfortunately is rarely followed for any length of time once the individual leaves a physical therapy program and is expected to conduct the HEP independently. In addition, the recidivism back to physical therapy once a HEP has failed wastes thousands of dollars.
On an ending note, and to clarify between a FES and Personal Trainer, please note the comparisons below:
Functional Exercise Specialist = Disabled population
Personal Trainer = Abled-body, healthy population
Now that you have the knowledge and understanding of the therapy continuums available to people with disabilities, it is hoped that you will educate others about a Functional Exercise Specialist. The personal successes which clients achieve from functional exercise programs are notable by the care team who helps work with these individuals, but most of all by the client.