Medical Exercise Specialist........Master the Medical Exercise Process

The Foundation of a Thriving Medical Exercise Practice

Building a successful medical exercise practice goes beyond simply providing exercises; it requires a systematic process focused on client well-being, collaboration with medical professionals, and demonstrable effectiveness. This client-centric approach, known as the "Medical Exercise Process", is meticulously outlined in the Advanced MES Manual, providing medical exercise professionals with a comprehensive resource to establish this system within their practices or businesses. The Medical Exercise Process, as detailed in the manual, serves as the foundation for delivering exceptional care, attracting referrals, and ultimately building a thriving practice.

Initial Client Interaction:

A new client's journey often begins with an inquiry, perhaps driven by a medical referral, online research, or recommendations. During this initial contact, the focus should be on understanding their needs and determining if medical exercise is appropriate. A structured questionnaire can be helpful for gathering basic information and screening for red flags. For instance, the MET-Q form suggested by the AMES Manual can be a valuable tool for this purpose.

Comprehensive Assessment:

A thorough assessment is crucial to lay the groundwork for a successful program. This involves:

• Review of Intake Forms: Carefully review completed forms, especially the medical history, paying close attention to the client's diagnosis, reported symptoms, and any medical interventions they've received. The AMES Manual provides sample forms for client intake, including medical history and liability forms, ensuring you collect essential information while maintaining confidentiality.
• In-Depth Medical History Interview: Go beyond the information on forms, engaging the client in a comprehensive conversation. Clarify details about their condition's onset, progression, and management, uncovering potential red flags that might necessitate referral back to their medical provider. The AMES Manual offers guidance on key areas to explore during this interview.
• Physical Assessment: A comprehensive physical assessment provides a baseline for measuring progress and tailoring the exercise program. Key components include:
• Vital Signs: Accurately measure and record vital signs like blood pressure, heart rate, and respiratory rate. The AMES Manual provides detailed procedures for ensuring accurate measurement.
• Postural Assessment: Observe the client’s posture, noting any asymmetries or deviations that might contribute to their condition. The AMES Manual highlights the importance of postural screening.
• Range of Motion (ROM) and Flexibility: Evaluate joint ROM using a goniometer, recording measurements and noting any pain or limitations. The AMES Manual provides goniometry procedures and guidelines.
• Muscle Strength: Assess muscle strength using manual muscle testing techniques and a standardized grading scale. The AMES Manual offers guidance on these procedures.
• Special Tests: Perform special tests, as appropriate, to evaluate joint stability, muscle function, and potential impairments. Remember, these tests are not for diagnosis, but for assessing client status and exercise readiness. The AMES Manual provides a comprehensive library of special tests.
• Functional Assessments: Use Functional Assessment Scales to assess the client's ability to perform daily activities. The AMES Manual suggests various scales and offers guidance on their administration.
• Gait Analysis: Analyze the client’s gait, focusing on identifying dysfunctional movement patterns that might need correction, particularly for clients with neurological conditions. The AMES Manual dedicates a section to gait analysis techniques.

Goal Setting and Exercise Program Development:

Once the assessment is complete:

• Identify Contraindications and Precautions: Thoroughly review the client's medical history and assessment findings to identify any activities or exercises that should be avoided or modified. The AMES Manual provides specific contraindications and precautions for various conditions.
• Establish Short-Term and Long-Term Goals: Collaborate with the client to set SMART goals that address their functional deficits and align with their desired outcomes. The AMES Manual stresses the importance of SMART goals in the POE.
• Develop the Plan of Exercise (POE): Create a personalized exercise program, documented in the POE, that systematically progresses through phases, starting with foundational exercises to improve strength, stability, and mobility, and gradually advancing to functional training and potentially even human performance training. The AMES Manual offers detailed exercise guidelines and protocols for numerous medical conditions, encompassing various training phases.

Exercise Training and Ongoing Services:

During training sessions:

• Implement the POE: Guide the client through their prescribed exercises, providing clear instructions and modifications as needed. The AMES Manual emphasizes the use of a phased approach to MET.
• Monitor Client Responses: Observe the client's responses to exercise, noting any changes in vital signs, pain levels, or function. Adjust the exercise program accordingly to ensure safety and optimal progression. The AMES Manual highlights the importance of close monitoring during sessions.
• Track Progress Using Functional Outcome Measures (FOMs): Regularly reassess the client’s progress using FOMs such as ROM measurements, strength assessments, pain scales, and functional assessments. Document these findings to demonstrate the effectiveness of the program and support continued care. The AMES Manual provides a comprehensive list of FOMs and emphasizes their significance in tracking progress.
• Provide Lifestyle Education: Offer guidance on lifestyle modifications that can support the client’s overall health and well-being. This might include advice on nutrition, stress management, sleep hygiene, and other relevant factors. The AMES Manual encourages addressing lifestyle factors as part of MET.
• Meticulous Documentation: Document all session details, including exercises performed, sets, reps, intensity, client responses, and any modifications made, using a session log. The AMES Manual provides a sample MET Training Session Log Form to ensure consistent record-keeping.

Communication with Medical Professionals:

Maintain open communication with referring medical professionals to foster a collaborative approach to client care. The AMES Manual recommends a systematic approach to communication:

• Referral Form: If the client comes with a medical referral, carefully review it to understand the referring professional’s recommendations and expectations. The AMES Manual provides a sample referral form.
• Introductory Letter: Upon initial client contact, promptly send an introductory letter to the referring medical professional, confirming the client’s enrollment in your program and requesting any relevant information or precautions. The AMES Manual recommends this practice.
• Assessment Summary: After completing the assessment, send a detailed summary of the findings, including goals, identified deficits, and the initial exercise plan, to the referring professional. The AMES Manual offers sample assessment forms for various body regions.
• Progress Reports: Send regular progress reports, typically every 30 days or in alignment with follow-up appointments, highlighting the client’s achievements, changes in FOMs, updates to the exercise program, and any recommendations for modifications to the care plan. The AMES Manual provides a structured format for progress reports.
• Open Communication: Maintain open lines of communication, such as phone calls or emails, to promptly address any concerns or seek clarification on the client’s care. The AMES Manual emphasizes the importance of open communication channels.

Discharge and Conclusion:

• Discharge Summary: Upon program completion or discontinuation, prepare a discharge summary, outlining the client’s achievements, final functional status, and recommendations for ongoing exercise and lifestyle management. The AMES Manual offers a sample discharge summary form for consistent documentation.

By implementing this systematic and collaborative approach, you can effectively manage your medical exercise clients, demonstrate the value of your services, and cultivate strong relationships with medical professionals. The AMES Manual, available in digital or print form at www.AMESManual.com, offers a comprehensive resource for establishing and refining these processes, empowering you to build a thriving and impactful medical exercise practice.