What is the difference between physiotherapist and exercise therapist?

What's the difference between a personal trainer and an exercise therapist (clinical exercise physiologist)?

What is your usual procedure when seeing a new patient or client?

What is the difference between physiotherapist and exercise therapist?

By definition, a physiotherapist is primarily concerned with the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including paraffin, shortwave and microwave diathermy, and ultrasonic heat), hydrotherapy, electrical stimulation, and light to assist in habilitating or rehabilitating patients and restoring function after an illness or injury (Mosby’s Medical Dictionary, 8th ed. 2009).

Exercise therapy stems from athletic therapy and clinical exercise physiology (or adapted physical activity) which are specializations within the field of exercise science and exercise physiology. Exercise therapists have commonalities with physiotherapist (physical therapist) in their training as they also study human anatomy, physiology and are trained in assessment and rehabilitation technique of the spine and pelvis as well as extremities. In addition, they are also trained to work with persons with chronic diseases and special populations (such as cardiac population, diabetes, physical disability, obesity, elderly, etc...) and develop adapted physical activity programs for these populations. Educational experience of the exercise therapist includes: biomechanics, musculoskeletal and postural evaluation, equipment fitting and selection, conditioning programs, prophylactic and supportive taping, injury assessment, basic emergency life support, first aid, rehabilitative techniques, modality therapy, and utilization of techniques facilitating a safe return to participation in sports or exercise, principles of strength and conditioning and nutrition. Further more, they are trained to assess health and performance including cardiopulmonary and metabolic tests, body composition, flexibility, muscle strength, agility, balance, coordination, speed, power, and reaction time. They also develop and administer exercise prescriptions and programs and are involved in various areas of health promotion and lifestyle change within a population, be it corporate, governmental, municipal, etc...

Basically, an Exercise Therapist can, not only provide rehabilitative type of exercise program in cases of injury or surgery, but primarily assist physicians in the treatment of chronic disease by providing specialized exercise prescription for these patients to prevent future complication (or reduce the risk of future complications) and improve overall health and quality of life. This is a more comprehensive (integrative) approach to overall good health and disease prevention for the long term.

What's the difference between a personal trainer and an exercise therapist?

A personal trainer usually has taken a preparatory course in exercise prescription and exercise technique as well as some basics in human anatomy and body function. This is in preparation for examinations which entitle him or her to acquire a certificate of qualification or proficiency. Usually anyone can undertake this training at any time regardless of their previous background, experience or knowledge. Generally, no university degree is required.

An exercise therapist deals mostly with persons that have a chronic disease or disability.  They perform exercise testing and develop supervised exercise programs that are integrated with or become part of the patients treatment plan.  They are also qualified to train the athletic population.  There are many certifications and governing bodies an exercise therapist can apply for and adhere to. He or she can undergo an examination from the athletic therapy association (this is the Canadian Athletic Therapy Association) to become a certified athletic therapist in which case he or she will be more specialized to work with athletes and the active population. Other certifications include the Certified Strength and Conditioning Specialist (CSCS) which is issued by the National Strength and Conditioning Association. The American College of Sports Medicine (ACSM) also issue certificates such as Clinical Exercise Specialist (CES) and Registered Clinical Exercise Physiologist (R-CEP) among others. All of the above certifications require strict pre-requisites from candidates such as a recognized and accredited university degree in the field of health and/or exercise science and administer comprehensive in-depth examinations before the certification is issued. They are well known and respected in the field of health and exercise science and serve as references in these fields and require their certified members to fulfill a minimum number of Continued Education Units (CEU's) to retain their certified status. These CEU's are continuing education courses, conferences, lectures or workshops that members need to attend or take to acquire the necessary CEU’s to keep their certified status throughout the years. In other words, these members generally have undergone many years of university studies in the fields of health and exercise science and bring a certain amount of experience before acquiring the certified status. All of the above certifying association release research journals which include research on such topics as health concerns (specific and general), exercise, fitness, rehabilitative training, nutrition, lifestyle, sport specific training, adapted physical activity to name a few. Aside from the many years of university study in specific life and health sciences and the reputable certifications, a patient or client also benefits from valuable experience acquired either through internship and more importantly real life experience. This in itself has tremendous value.

The additional benefit of acquiring the services of a professional with my background is that you will effectively decrease the likelihood of injury while exercising as well as being guided through the most efficient way to train to benefit the most out of your workouts. You can rest assured that you will be taught proper technique, you will learn about how your body works (physiology, biomechanics, anatomy, etc..), what to eat, why sleep is important and much more, thus getting a more holistic experience.

What is your usual procedure when seeing a new patient or client?

For a patient that is referred by a health professional, the initial assessment is conducted with the patients particular condition in mind. In other words, if the patient is referred because they had back pain issues in the past and need continued strengthening and conditioning of the core musculature first and then the rest of the body, then an assessment specific to the core will be conducted with particular attention to posture among other things. Depending on the problem(s) the patients present or the reason they have been referred, this will be prioritized and addressed first. By using this method, the patient and health professional can rest assured that they will get the help they need safely and effectively based on sound science based principles and perhaps more importantly will have the opportunity to continue to progress and become fit beyond their present state by adhering to a fitness program that hopefully becomes an integral part of their life. So as you can see, there is a superior advantage in the fact that there is a transition from a specific rehabilitative type of conditioning to a more generalized complete fitness approach eventually addressing the person as a whole.

The first thing that needs to be done is an assessment or evaluation of the individual when first seen. If a client is simply seeing me for health maintenance and wants to progress in their strength levels and be challenged with new conditioning methods, then a preliminary fitness assessment is conducted in order to determine levels of muscular endurance, muscular strength, cardiovascular endurance, flexibility, heart rate, blood pressure, proprioception (related to balance), body composition, basic nutritional assessment, lifestyle assessment, basic lipid profile (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides). This provides a baseline from which we can assess the present fitness level of the individual as well as their health risk and from there, realistic goals and objectives can be set accordingly.