chapter
Chapter
14 Careers in Therapeutic
Exercise
14
Careers in
Therapeutic
Exercise
Chad Starkey
Therapeutic Exercise Defined
The systematic and scientific application of
exercise and movement experiences to
develop or restore muscular strength,
endurance, or flexibility; neuromuscular
coordination; cardiovascular efficiency; and
other health and performance factors.
Figure 14.1
Goals of Therapeutic Exercise
Professionals
To help people restore lost function
(rehabilitative therapeutic exercise) or
acquire skills and functions considered
normal or expected (habilitative therapeutic
exercise).
Types of Therapeutic Exercise
• Rehabilitative therapeutic exercise:
Processes and treatments that restore skills
or functions that were previously acquired
but have been lost because of injury,
disease, or behavioral traits
• Habilitative therapeutic exercise: Processes
and treatments leading to the acquisition of
skills and functions that are considered
normal and expected for an individual of a
certain age and status
Therapeutic Exercise Focus
Both rehabilitative and habilitative
therapeutic exercise focus on
developing the body’s systems so
people are less likely to become
injured or diseased.
Rehabilitative Therapeutic Exercise
• Exercise therapy for the rehabilitation of
musculoskeletal injuries
• Exercise therapy for rehabilitation of athletic
injuries
• Exercise therapy for rehabilitation of postsurgical
trauma
• Exercise therapy in cardiopulmonary rehabilitation
• Exercise therapy for the rehabilitation of older
populations
• Exercise therapy for the rehabilitation of
psychological disorders (mind–body relationship)
Habilitative Therapeutic Exercise
• Exercise therapy for specialized habilitation
• Exercise therapy for habilitation of obese
populations
• Exercise therapy for habilitation of children
with developmental disorders
• Exercise therapy for habilitation of general
fitness
Sedentary Lifestyles
Societal changes have negatively affected
the health of a significant portion of the
population. The information age has
created a relatively sedentary group of
people. Therapeutic exercise—even in the
form of casual recreation—can offer a
more balanced lifestyle.
Therapeutic Exercise Settings
•
•
•
•
Inpatient facilities
Outpatient clinic settings
Sport team settings
Private practice
Overviews of Professions in
Therapeutic Exercise
• Credentials for each profession vary and
also change regularly, so be sure to monitor
any changes taking place in your profession
to ensure that you are meeting the required
standards for employment for education,
licensure, and so on.
• A brief overview of each therapeutic
exercise professional follows.
Athletic Trainer
• Responsible for the prevention, evaluation,
management, treatment, and rehabilitation
of athletic injuries
• Accredited athletic training program
• Clinical rotations
• Education and credentials
Certification through the Board of Certification for
Athletic Trainers
• Employment opportunities
Rapidly growing field, especially as the variety of
settings for employment increase
Sample Course Work for Athletic
Training
• Acute care
• Administration
• Assessment and
evaluation of injuries
and illnesses
• Biomechanics*
• Chemistry
• Counseling
• Exercise physiology
• Gross anatomy
• Human anatomy
•
•
•
•
•
•
•
•
•
* Still called kinesiology at some universities.
Human physiology
Injury prevention
Nutrition
Pathology
Pharmacology
Physics
Statistics
Therapeutic exercise
Therapeutic modalities
Clinical Exercise Physiologist
• Cardiac, pulmonary, and metabolic disease care
– Exercise testing
– Exercise prescription
– Program administration
• Employment settings
• Education and credentials
– Recommended undergraduate and graduate degree
– Specialized courses and certifications (ACSM)
• Exercise specialist
• Registered clinical exercise physiologist
– Required credentials vary by state
• Employment opportunities
Growth in aging population resulting in growth of these types of
positions
Sample Course Work for Cardiac Rehabilitation
Specialist or Clinical Exercise Physiologist
• Advanced cardiac life
support
• Cardiopulmonary
assessment
• Cardiopulmonary disease
• Cardiopulmonary
physiology
• Cardiopulmonary
technology
• Clinical biomechanics*
• Echocardiography
•
•
•
•
•
•
•
•
•
* Still called kinesiology at some universities.
Electrocardiography
Exercise physiology
Exercise prescription
Imaging devices
Nutrition
Pathophysiology
Pharmacology
Physics
Respiratory care
Occupational Therapist
• Helps injured or ill individuals reach their maximum
level of independence by emphasizing the
acquisition and retention of functional skills
• Employment settings
• Education and credentials
–
–
–
–
National Board for Certification in Occupational Therapy, Inc.
State licensure
OT: Master’s degree (as of 2007)
OTA: two-year degree program
• Employment opportunities
Growth related to increased services being provided to children
Sample Course Work for Occupational
Therapy
Occupational Therapist
• Abnormal psychology
• Assistive technology
• Biology
• Biomechanics*
• Gross anatomy
• Human anatomy
• Human performance abilities
• Human physiology
• Neuroanatomy
• Occupational analysis
• Physical dysfunction
• Psychology
• Statistics
Occupational Therapy
Assistant
• Biomechanics*
• Human anatomy
• Human development
• Human physiology
• Neurology
• Occupational therapy
procedures
• Organization and
administration
• Psychology
• Psychosocial dysfunction
*Still called kinesiology at some universities.
Physical Therapy Specialty
Certifications
Physical Therapist
• Provides rehabilitative care to a diverse patient
population with a wide range of injuries, illnesses,
and diseases
• Education and credentials
– Educated as a generalist, tends to specialize in practice (seven
specialty areas)
– Physical therapist (plans, directs, implements patient care)
• Accredited master’s degree program (doctorate of PT
required by 2020)
• State licensure
– Physical therapist assistant
• Delivers care under direction of PT
• Accredited two-year program
(continued)
• State licensure
Physical Therapist (continued)
• Employment settings
– Geriatric care
– Pediatric care
– Sport physical therapy
• Employment opportunities
Increased survival rates of accident victims along with
increased support from employers indicates growth
in job opportunities.
Physical Therapist’s Role
A physical therapist administers patients’
programs and performs the required
functional evaluations. A physical therapist’s
assistant assumes much of the hands-on
patient care, functioning under the physical
therapist’s supervision.
Sample Course Work for Physical Therapy
Pre–Physical Therapy
• Biology
• Chemistry
• Exercise physiology
• Physics
• Human anatomy
• Human physiology
• Psychology/developmental
psychology
Physical Therapist (EntryLevel Clinical Doctorate
Degree)
• Biomechanics*
• Cardiopulmonary evaluation
and treatment
• Clinical medicine
• Geriatrics
• Gross anatomy
• Management and
reimbursement
• Medical ethics
• Musculoskeletal evaluation
and treatment
• Musculoskeletal imaging
• Neuroanatomy
• Neurological evaluation and
treatment
• Pathology and
pathophysiology
• Pediatric evaluation and
treatment
• Pediatric neurology
• Pharmacology
• Psychological and social
aspects of disability
• Statistics and research design
• Therapeutic modalities
(continued)
Sample Course Work for Physical
Therapy (continued)
Physical Therapy Assistant (Two-Year
Associate’s Degree)
• Biomechanics*
• Clinical practice
• Human growth and development
• Physical disabilities
• Physical therapy procedures
• Therapeutic exercise
• Therapeutic modalities
*Still called kinesiology at some universities.
Therapeutic Recreation Specialist
• Treats patients with physical disability or impaired
mental function: restores, remediates, or
rehabilitates to improve function and
independence; also focuses on social integration
(treatment team approach)
• Education and credentials
– Bachelor's degree in therapeutic recreation
– Internship under a certified recreation specialist
– National certification exam: Certified therapeutic recreation
specialists (CTRS)
• Employment settings
• Employment opportunities
Limited growth because of cuts in hospital settings
Sample Course Work for Therapeutic
Recreation
• Introduction to therapeutic
recreation
• Assessment and
documentation in
therapeutic recreation
• Therapeutic recreation
interventions and
techniques
• Leisure education
• Program planning and
design in therapeutic
recreation
• Professional trends and
issues in therapeutic
recreation
• Human growth and
development across the life
span
• Abnormal psychology
• Anatomy and physiology
• General recreation course
work
Strength and Conditioning Specialist
• Maximizes physical performance, reduces the
frequency of injury, and decreases the possibility of
cardiovascular disease by designing programs for
the specific needs of the individual (sport and
activity specific)
• Education and credentials
– Bachelor’s degree in kinesiology preferred, required for some
certifications
– Certifications recommended (e.g., National Strength and
Conditioning Association Certified Strength and Conditioning
Specialist)
– Current CPR certification
• Employment settings
• Employment opportunities
Careers in Therapeutic Exercise
• Fulfill a societal need
• Assist in attaining desired levels of
fitness (habilitation)
• Assist in regaining lost function
(rehabilitation)
• Cover a wide range of populations
– Newborns to geriatrics
– Athletes to unskilled