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Medical exercise training (MET) will grow tremendously over the next two decades. Medical Exercise Specialists (MES) will also see the types of clients they manage expand greatly. To manage this wide range of clients medical exercise professionals (MedXPROs) will need a logical thought process to develop safe and effective medical exercise programming. The Medical Exercise Training Institute (METI) developed this 6 Point MET Client Management system more than 20 years ago and it is taught to every METI Medical Exercise Specialist, Post Rehab Conditioning Specialist and Medical Exercise Program Director. This medical exercise “critical thinking” model should be used when providing all medical exercise services.

The 6 Point MET Client Management System includes the following:

1. Understand the related clinical anatomy/pathology of the client’s condition. Anatomy and pathology are the basis of every aspect of health care regardless of the practitioner delivering it. This begins during the initial conversation with the client, he or she should provide their diagnoses. Many clients may not known their diagnosis so you may have to contact their physician, physical therapist or chiropractor for this information. The exercise program depends on your understanding and knowing how exercise will impact the organ systems, joints, muscles, etc involved in the client’s condition. If you dont understand the anatomy and pathology of your client’s conditions you will not achieve a positive outcome for the client.

2. Recognize the contraindicated activities and exercises of the client’s condition(s). The first job of any fitness or wellness professional is to do “no harm”. Knowing what NOT to do with a client is half the battle in MET. This is absolute. You may have a wide range of exercises you have learned but to have your client perform an exercise that exacerbates their condition is unacceptable. As the exercise expert, the client has sought you out or the medical professional has referred the client….its important you know what exercises and activities NOT to do as you manage the client’s program.

3. Use key assessment procedures on the appropriate regions or joints of the body based on the client’s condition. Assess the important areas using the appropriate techniques. Remember, assessment techniques are provocative and may flare the client conditions. Use only the essential assessment procedures. Use the assessment findings to develop the exercise program.

4. Incorporate indicated activities and exercises. There are certain exercises which will enhance the client’s condition. Recognize and incorporate these exercises. Also recommend those activites into the client’s lifestyle which will enhance their outcome.

5. Understand progression guidelines and functional goals. This is where personal training and medical exercise training differ. In many instances the goal of personal training is for the client to feel better, lose weight or have more energy. These goals are aesthetic. But medical exercise training has goals which focus on the client’s improvement in some aspect of function such as gait, range of motion and/or strength. Medical exercise training should address and enhance the residual functional deficits found in the assessment.

6. Use a protocol-based approach. Protocols simply keep small details from falling through the cracks or being ignored. Protocols make sure all the T’s are crossed and the I’s dotted. Medical exercise rotocols also serve to enhance the level of professionalism as well as raise the standard of exercise.

Every medical exercise professional should use this 6 Point thought process when managing clients with medical conditions. This 6 point system gives the medical exercise professional a simple process to use as the foundation of their medical exercise management.

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