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Professional- licensure, reimbursement, other

CEP vs AT and PT
Nicholas Lionetti
I am a CEP and an Exercise Science professor curious about the scope of overlap between the clinical exercise physiologist, the athletic trainer, and the physical therapist. My question is, can the CEP administer hydrotherapy, i.e. use of a whirlpool, to help an athlete treat tight hamstrings or prescribe balance exercises for a recent ankle injury, or is this solely the AT's and PT's scope of practice? The reason I am asking this question is because our college has opened a recovery/athletic training room and has asked me to incorporate hydrotherapy, thermotherapy, cryotherapy, physical rehabilitation, etc. into the Exercise Science curriculum, and I want to make sure that I am not teaching/administering beyond my scope of practice as a CEP. Any guidance on this issue would be much appreciated.
Clinton A. Brawner
It seems unlikely that whirlpool use, heat/ice, stretching, and balance exercises are limited to PTs/ATs. Cryotherapy is currently perceived as a non-medical therapy that is delivered at spas by minimally trained individuals. I'm not familiar with the risk/benefit ratio of it. It is possible the training should be elevated, but current practice suggests it is not limited to PTs/ATs. That said, it is outside the scope of the CEP to diagnose injuries.
Brittany Overstreet
Hi all,

There has been a LOT of discussion regarding scope of practice within CEPA. I myself have been pursing licensure for CEPS in Delaware and have also had MANY discussions with PT and AT to avoid "stepping on toes". While there are not hard rules right now, I would encourage all practicing CEPs and those preparing future CEPs to try and stick within what/how CEPA defines a CEP's role which includes "Clinical Exercise Physiology services focus on the improvement of physical capabilities for the purpose of: (1) chronic disease management; (2) reducing risks for early development or recurrence of chronic diseases; (3) creating lifestyle habits that promote enhancement of health; (4) facilitating the elimination of barriers to habitual lifestyle changes through goal-setting and prioritizing; (5) improving the ease of daily living activities; (6) and increasing the likelihood of long-term physical, social and economic independence"

Personally, I feel that hydrotherapy may be outside the SOP for a CEP. I would also encourage you to follow the job task analysis outlined by ACSM (can be found on certification page). If it is not outlined in there, sufficient evident has not be found to support it as one of our tasks. While I do believe CEPs have many skills that could allow us to perform these tasks in the future.

(all thoughts/opinions are my own)
Clinton A. Brawner
@Brittany- Good comments.
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