Cheema Birinder S, Robergs Robert A, Askew Christopher D
School of Science and Health, University of Western Sydney, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia,
Sports Med. 2014 Jul;44(7):869-77. doi: 10.1007/s40279-014-0173-y.
Exercise can be prescribed to prevent, manage, and treat many leading non-communicable diseases (NCDs) and underlying risk factors. However, surprisingly, Australia is one of only a few countries where allied healthcare professionals with specialized university education and training in exercise prescription and delivery provide services within a government-run healthcare system (Medicare). This article presents data on Medicare-funded services provided by accredited exercise physiologists (AEPs) from the inclusion of the profession in the allied healthcare model (January, 2006) to the end of 2012. We conceptualize these data in relation to current NCD trends, and outline recommendations that can potentially help curtail the current chronic disease burden through the further integration of exercise professionals into the healthcare system in Australia, and internationally. From 2006 to 2012, the number of AEPs in Australia has increased 563 %. This rise in AEPs has been paralleled by increased delivery of services for eligible patients with a chronic medical condition (+614 %), type 2 diabetes mellitus (+211 to 230 %), and of Aboriginal and Torres Strait Islander descent (+343 %). These trends, which were developed through the "early years" of the profession, are encouraging and suggest that AEPs have taken up a vital position within the healthcare system. However, the total number of services provided by AEPs currently remains very low in relation to the prevalence of overweight-obesity and type 2 diabetes in Australia. Furthermore, services for Aboriginal Australians are very low considering the extreme burden of chronic diseases in these vulnerable populations. We provide some recommendations that may help the exercise physiology profession play a greater role in tackling the NCD burden and shift the healthcare model in a direction that is more proactive and focused on disease prevention and health, including the early identification and treatment of major upstream risk factors.
运动可用于预防、管理和治疗多种主要的非传染性疾病（NCDs）及其潜在风险因素。然而，令人惊讶的是，澳大利亚是少数几个国家之一，在这些国家中，接受过大学专业教育和运动处方与实施培训的专职医疗保健专业人员在政府运营的医疗保健系统（医疗保险）内提供服务。本文呈现了自该专业纳入专职医疗保健模式（2006年1月）至2012年底，经认可的运动生理学家（AEPs）提供的由医疗保险资助服务的数据。我们结合当前非传染性疾病的趋势对这些数据进行概念化分析，并概述一些建议，这些建议可能有助于通过在澳大利亚及国际上进一步将运动专业人员融入医疗保健系统，来减轻当前的慢性病负担。从2006年到2012年，澳大利亚的运动生理学家数量增长了563%。运动生理学家数量的增加伴随着为符合条件的慢性病患者（+614%）、2型糖尿病患者（+211%至230%）以及原住民和托雷斯海峡岛民（+343%）提供的服务增加。这些在该专业“早期”发展起来的趋势令人鼓舞，表明运动生理学家在医疗保健系统中占据了重要地位。然而，就澳大利亚超重肥胖和2型糖尿病的患病率而言，运动生理学家目前提供的服务总数仍然非常低。此外，考虑到这些弱势群体中慢性病的极端负担，为澳大利亚原住民提供的服务非常少。我们提供了一些建议，可能有助于运动生理学专业在应对非传染性疾病负担方面发挥更大作用，并使医疗保健模式朝着更积极主动、注重疾病预防和健康的方向转变，包括早期识别和治疗主要的上游风险因素。
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