Patients commonly seek treatment for a primary condition, for example in the worker’s compensation space. An Exercise Physiologist’s goal is to prescribe an exercise programme that addresses the primary condition. However, patients can present with co-existing comorbidities which ultimately can impact their exercise programme. Patients with a comorbidity can participate in exercise if the prescribed exercise is appropriately modified to the presented comorbidities without impeding the effectiveness towards the primary condition or patient’s goals.
Part of an Exercise Physiologist’s role is to recognise a patient’s comorbidities and their associated contraindications and limitations to exercise. To assist with this process the i3-S strategy has been developed to assist in recognising comorbidity-related adaptations to exercise rehabilitation to a primary condition. It is broken into 4 steps: assess health status, comorbidity contraindications/restrictions, exercise adaptations and synthesis of information.
1. Assess Health Status
2. Inventory of Comorbidity Contraindications and Restrictions
3. Inventory of Adaptations to Exercise
4. Synthesis of Information
Ultimately, this strategy can be implemented to ensure an evidence-based exercise program is prescribed targeting their primary condition whilst taking into account their co-existing comorbidities. Throughout the process, emphasis is placed on applying clinical reasoning. Patients should be viewed in their whole rather than their index condition.
References:
Caitlin Chase
Workers Compensation Specialist (AEP, ESSAM)
Exercise Rehabilitation Services ‑ WA