46 Occupational Outlook Quarterly ● Summer 2001

Megan Lukenbill helps cardiac

patients develop stronger

hearts, emphysema patients

healthier lungs, and arthritic patients

freer movements. As a clinical exercise

physiologist at the Kosciusko Community Hospital in Warsaw, Indiana, she

uses physical activity to treat people

with illnesses. For Megan’s patients,

exercise is often the best medicine.

Patients with heart disease, diabetes,

cancer, and a number of other conditions benefit from physical activity. But

different activities are good for certain

types of patients, and some activities are

dangerous for people with particular

medical conditions. Exercise physiologists like Megan prescribe exercise

programs for each patient, monitor

patients while they exercise, and track

each person’s progress.

When someone comes to the

wellness center at the hospital where

she works, Megan first conducts a

fitness test to assess his or her

physical condition. She usually asks

patients to walk on a treadmill after

connecting them to an EKG machine,

to track heart rate and rhythm; a pulse

oximeter, to track the oxygen in the

blood; and a blood pressure cuff, to

gauge the pressure exerted by the

heart in pumping blood throughout

the body. Megan also uses weights and

other instruments to measure patients’ strength and flexibility. Based

on the results of these tests, she

prescribes appropriate exercises.

In designing activity prescriptions,

You’re a

what?

by Olivia Crosby

Olivia Crosby is a contributing editor to the OOQ,

(202) 691-5716.

Megan uses her understanding of how

exercise affects the body. For example,

when working with patients who have

lung disease—which can cause shortness of breath, resulting in decreased

oxygen levels—she recommends

exercises that don’t deplete too much

of the oxygen in the blood. “Larger

muscles use more oxygen,” she says.

“So when someone with lung disease

comes in, we usually start with lowintensity exercises. Someimes, we

recommend an arm cycle instead of a

regular bicycle because the muscles in

the arms are smaller than the muscles

in the legs.” She slowly increases the

difficulty of the activity to strengthen

lung function.

Megan has an abundance of exercises to choose from when prescribing

a regimen. She might ask patients with

muscle weakness to push against an

elastic band to build strength, eventually

guiding them to more complex weight

equipment. Most of the equipment her

patients use is the same as that found

in most gyms, but some is specially

designed for clinical patients.

Evaluating patients and prescribing

exercises are the first stages of

Megan’s work. She also demonstrates

the exercises she recommends and

explains the purpose of each activity.

“Some of the people we help have

never exercised before,” Megan says.

To be sure they understand her

prescription, she teaches each activity

one motion at time.

The next phase of a hospital-based

exercise program is monitoring

patients as they work out. Megan and

two other staff members track up to

eight patients at a time, making sure

they exercise properly. Megan watches

a computer screen that shows each

patient’s heart rate, blood oxygen

level, and blood pressure throughout

the regimen. Based on these measurements, she asks patients to increase or

decrease their activity. “If patients

exercise too much, they risk injury,”

says Megan. “For example, if lung

patients exercise when they don’t

have enough oxygen in the blood, the

body will start to break down muscle.

But if patients exercise too little, they

won’t grow stronger.”

Supervising eight patients at the

same time requires concentration.

Exercise physiologists stay alert for

patient difficulties and are prepared

to handle emergencies. They stand

ready to assist patients who have

heart attacks, fainting spells, allergic

Exercise Photos courtesy of Megan Lukenbill

Megan Lukenbill assesses a patient’s fitness

level before prescribing an exercise program.
Occupational Outlook Quarterly ● Summer 2001 47

reactions, or other crises.

But it takes more than scientific

knowledge and a close eye to practice

exercise physiology. An outgoing

personality and the ability to inspire and

motivate patients are essential to the

job. “You have to be good at relating to

people and giving them confidence,”

Megan says. “People are scared when

they start, especially people who have

had heart attacks.” Megan reassures and

encourages her patients.

And one of the best forms of

encouragement for exercise patients

is their progress reports. Megan plots

a patient’s increasing strength on a

chart and writes a detailed report

describing his or her improving fitness

capacity. She shares these reports with

her patients and their doctors.

Like many exercise physiologists,

Megan takes her skills outside the

hospital and into the community

several times each month. She conducts health screenings and exercise

education classes at local businesses,

checking employees’ blood pressure,

body composition, and strength and

teaching people about the importance

of exercise and good nutrition.

Clinical exercise physiologists like

Megan often work in hospitals,

physical therapy offices, and sports

medicine clinics. Other types of

exercise physiologists manage fitness

programs for corporations and fitness

centers. Some exercise physiologists

work in professional athletic training

programs, using their knowledge of

the effects of exercise to analyze each

athlete’s sport and design an exercise

program tailored to that sport.

The Bureau of Labor Statistics does

not collect data on exercise physiologists. But according to industry

sources, salaries vary widely, based in

part on where exercise physiologists

work. Most earn between $20,000 and

$45,000 annually; those with doctoral

degrees usually earn more.

Most exercise physiologists have at

least a bachelor’s degree in exercise

science or exercise physiology. Among

other subjects, they study biology,

anatomy, and chemistry. Megan also

has a master’s degree, as do many

exercise physiologists who work in

hospitals. Those with doctoral degrees

often teach exercise science in

colleges and universities and conduct

research on the effects of exercise.

 And exercise physiology jobs

usually require that applicants have

CPR certification. Applicants for jobs

in most hospitals must have certification in basic life support and basic or

advanced cardiac care.

Professional registration and

certification increases exercise

physiologists’ employment opportunities. Clinical exercise physiologists may

register with the American College of

Sports Medicine after earning a

master’s degree, passing an exam, and

gaining at least 12,000 hours of

hospital experience. The organization

also certifies physiologists as exercise

specialists if they have a bachelor’s

degree or equivalent experience, pass

an exam, and gain at least 600 hours

of hospital experience. And the

American Society of Exercise Physiologists offers an exercise physiologist

certification for workers who have a

physiologist

bachelor’s degree in the field and pass

an exam. To keep certification current,

exercise physiologists must take

continuing education classes.

Megan enjoys learning about the

latest scientific discoveries in her field,

but what she likes best is using those

discoveries to achieve results. “People

don’t realize the importance of

exercise,” she says. “We’ve had

patients with congestive heart failure

return to normal because of exercise.

Not all recoveries are so dramatic, but

we always strive to make people

healthier and stronger.”

Clinical exercise physiologists like Megan

monitor and evaluate patients’ progress.