What is an Exercise Referral?
An Exercise Referral is a specific and formalised programme whereby a medical professional refers a patient to a fitness programme, often based within the community. It is not the same as a ‘recommendation’ to exercise. A formal agreement will exist between the referrer and the exercise project. Usually (though not exclusively) run by local authority leisure centres, they will typically ensure a 12 week supervised programme of physical activity tailored to suit the needs of the referrer and the referred client, with a view to improving their state of health.
The principal of referral to exercise was established in the early 90s and since that time a range of qualifications and competencies have been developed to ensure the safe and effective programming for clients with a range of medical conditions.
What level of instructor can work with referred clients?
The Exercise Referral Instructor (Level 3)
- An exercise referral instructor’s role includes designing, monitoring, adapting and implementing exercise programmes for individual clients with a range of medical conditions.
Occupational Role
- Assess, monitor and manage risk to clients arising from exercise participation throughout the referral period
- Analyse information relating to individual clients with regard to safe and effective programme design
- Identify, agree and review short, medium and long term goals to ensure the effectiveness of exercise programmes
- Promote a range of physical activity opportunities in accordance with the needs and health status of the clients
- Tailor progressive exercise appropriate to the medical condition using results from the physical/exercise assessments, medical information, national guidelines and client goals and objectives
- Develop and apply strategies to motivate clients to adhere to an exercise programme during the referral period
- Keep up to date with health and fitness industry developments and exercise guidelines for medical conditions
- Make the appropriate decisions relating to clients, where required, refer the client to a more appropriate professional
Occupational Competence
- Exercise Referral Instructors are aware of their professional role boundaries and are able to support clients with the following medical conditions
Respiratory Conditions
- Asthma
- Chronic obstructive pulmonary disease (COPD)
Musculoskeletal Conditions
- Osteoarthritis
- Rheumatoid arthritis
- Joint replacement
- Simple mechanical back pain
- Osteoporosis
Cardiovascular Conditions
- Hypertension
- Hypercholesterolaemia
Psychological/Mental Health Conditions
- Depression
- Stress
- Anxiety
Metabolic/Immunological Conditions
- Diabetes Type I and Type 2
- Obesity
What is a Specialist Exercise Instructor (Level 4)?
The specialist exercise instructor is able to demonstrate that they have met the Level 4 National Standards in one or more medical areas. Specialist exercise professionals are working within the healthcare sector and are also providing an interface between clinically-led exercise and community-based exercise programmes by designing, delivering, monitoring and evaluating structured, individualised physical activity programmes for clients. Additionally, they have a range of appropriate knowledge and skills that are aligned with current evidence-based, best practice guidelines regarding the affects of exercise on the specific condition/s for which they are qualified to work.
Specific medical areas covered by the specialist exercise instructors:
- Cardiac Rehabilitation
- Falls Prevention
- Low Back Pain
- Stroke
- Cancer
- Accelerated Rehabilitation Exercise (military only)
- Obesity and/or Diabetes
- Mental Health
- Chronic Respiratory Disease
- Strength and Conditioning
Guidance on how to join REPs at Level 4, or add a Level 4 specialism to an existing membership, is available here.