UniSA Clinical Exercise Physiology Conference

Student Presentations

Alex Gajewska and Suli Sharin

Same same but different 

Placement provides an extraordinary opportunity to see health therapists in their natural habitat. The intrepid student EP ventures out in to a vast array of landscapes; from the humble clinic room to the hustling hive of activity that is hospital based rehabilitation, wandering the corridors of nursing homes and negotiating land and water in gym and hydro based leisure centres. The more pioneering EP embarks on a more perilous path to the unprotected wilderness that is rural placement.

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Once arrived, our gallant EP must navigate their place amongst the hordes of health workers; a murder of medicos, a swarm of sisters, colonies of carers, plagues of PTs and a fever of physiotherapists, with the odd outcast OT or dietitian loitering at the fringes…

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What sets our protagonist, the EP apart from the herd? How does this magnificent beast the EP thrive in such congested environs? Behold!  Our hero, the steadfast and enlightened EP takes a holistic and measured approach to their prey; the client-centred goal. They take evidence as their base and deliver a prescription to help armour the client to attack the afflicting malady. Whilst roaming these realms, the particularly perceptive EP may note, that amongst their own kind, there are many roads to obtaining the Holy Grail; the client-centred goal.

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This presentation examines the different approaches EPs can take for client centred care.

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Presenting: Friday 7th December in 4pm-5pm session

Alison Burford

BREAKING: Murray Bridge High School Disability Unit students shine at inaugural sports day

“Being disabled should not mean being disqualified from having access to every aspect of life.”

—Emma Thompson—

I was lucky enough to experience a unique placement in a disability unit at a rural high school with 23 adolescents aged 13 to 19 ranging from years eight to 13. Presenting conditions included autism, intellectual disabilities, ADHD, Down syndrome and cerebral palsy.

The six weeks spent at this placement site was by far the biggest learning curve from my four years studying Exercise Physiology. The first week at the school was certainly the most challenging; learning about each student’s gross and fine motor development and level of cognition through observation and interaction.

It came as a surprise that the students have limited participation in the school sports day so the first ever Murray Bridge High School Disability Unit Sports Day became the end point for all their hard work.

The process started with subjective and objective assessments which guided individualised goals for each student. The tailored biopsychosocial prescription was delivered anywhere from one to four times a week for six weeks in 1:1 and group sessions.

Sounds simple, right? Not a chance. How do you perform a subjective assessment or obtain objective measures with a student who is nonverbal? How do you discuss goals with a student who has a 20 second attention span? How do you deliver tailored programs with limited equipment to students with heightened senses?

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This presentation will provide insight into how we overcame these challenges to prepare 23 spectacular, hardworking students for a successful sports day.

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Presenting Saturday 8th December in 11:15am-12:30pm session.

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Anna Vogelzang

A Complicated Initial Assessment

If you received a referral for a patient with a rare and complicated condition, what would you do? What questions should you ask, and what potential objective measures should be taken? Is exercise even safe for this patient?? I asked myself these questions prior to a unique initial assessment with a woman I will refer to as Mrs X. In this presentation, I will discuss my encounter with Mrs X, a 46-year-old woman who suffered an extensive aortic dissection.

An aortic dissection is a rare condition resulting from a tear in the intimal layer of the aorta, causing blood to pool in a false lumen between the intimal and medial layers. Symptoms mimic more common conditions, such as coronary artery disease, however only occur in a tiny fraction of patients presenting with chest and/or back pain.

There is some evidence to say that moderate intensity aerobic exercise is safe and beneficial for patients with an aortic dissection. Yet this is of little meaning for Mrs X, as her dissection was only part of the story; she also suffered a brain injury during surgery, several cardiovascular complications following her discharge and had a host of biopsychosocial barriers to exercise.

In this presentation, I will discuss what I learnt as a 4th year student from this unique assessment, exercise with an aortic dissection, and whether an exercise intervention is safe and beneficial for Mrs X.

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Presenting Friday 7th December in 4pm-5pm session.

Brianna Farmer

The power of Adaptive sports on reintegration to civilian life after medical discharge from the military.

Determination. Passion. Resilience.  Camaraderie. Fighting for your home soil. These are all key qualities that are often noted amongst our soldiers battling for us to live in this wonderful country. These are all qualities that are too often ripped from these warriors before they’re ready due to sustained physical and/or mental injuries. These are all qualities that, with the right guidance, the right support, the right opportunities, can be restored through participation in sport.

The Invictus Games offers a pathway for these wounded warriors to transition into a new form of national representation. An event focused around nations coming together to battle in the world of sport to prove they are not limited by their injuries. That through training and sport, they can regain a grasp on the life that was once theirs.

 
“12 months ago I couldn’t see a tomorrow, I couldn’t see hope. I didn’t think I could achieve. But the bike gave me that ability - to feel success and achievement”.

This road to recovery is not easy after defending your country. But through sport, these once-warriors can prove they are unconquerable. They can prove they are Invictus.

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Presenting Friday 7th December in 2:45pm-3:45pm session.

Brittany Higgins

Kicking little goals

Ever have the days where you think “why am I doing this?”, I can guarantee that majority of us university students have. A big struggle in society today is doing things or finding occupations that we are stuck in but don’t enjoy. It can sometimes be very difficult to find our calling and pinpoint the exact reason why we do what we do. This presentation discusses finding my why and the reason that I am proud to be becoming an Accredited Exercise Physiologist.

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I have found from placement experiences this year that there are clients that we cannot always help or achieve the biggest and best outcomes with, but it’s about doing what we can do. Accredited Exercise Physiologists aren’t here to find the cure for cancer, however we can implement small changes or perform little acts that can create big achievements in our client’s lives.

This presentation will display some personally significant cases that I have come across throughout placement this year, and how it’s not always the biggest things that can have an impact on a client’s life but also the small victories. I will discuss how I’ve witnessed EPs perform little acts that have contributed to a person without use of their fingers having the opportunity to write again, and a wheelchair bound client with MS gain more independence in being able to walk.

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Presenting Friday 7th December in 2:45pm-3:45pm session.

Christian Cirocco

What kind of EP will I be?

What kind of EP will I be? That is the million-dollar question.

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This presentation discusses the conflict and inner turmoil I faced when trying to decide what kind of clinician I was going to be when I finished my degree and whether I would be good enough. I would ask questions to my self like; which approach should I take? Which philosophy should I follow? Which cult should I join? And yet no answers…

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Each placement has been an amazing new experience, and yet they are also a whole new way of looking at how our profession can be approached.

This was both exciting and terrifying.

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This presentation showcases my journey to understanding the fact that there can be a thousand philosophies, approaches, strategies and tools to use in the EP world, but there doesn’t have to be one to rule them all! I will discuss some very similar cases across some very different placements to show that perfection doesn’t have to exist and in order to be the best clinician you can be, you truly just have to care.

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Presenting Friday 7th December in 2:45pm-3:45pm session.

Claudia Fantarella

Compliance as an Exercise Physiologist

Compliance, an issue I had always heard about, a struggle I knew I would face however, I had never considered how this issue would present to me or how I could help overcome it.  It wasn’t in the form of a mock motivational interview for my OSCE and it wasn’t a client not completing my wonderfully thought out home exercise program.

This first became alarming to me with a client who was not compliant to his own health.  Initial measures of blood pressure and blood glucose were well beyond guidelines for safe practice.  Here, I had to use the harsh reality of potential implications of his current health status to gain compliance for both my small bank of home exercises and to ensure he became compliant to monitoring his own health.

Compliance with a home exercise program or attendance to sessions was an aspect I had always considered however, compliance throughout a session was not something I saw myself facing. In my second and final placement blocks I experienced this through attempting to keep clients engaged throughout sessions and keeping them compliant with following instructions.

Although, some compliance occurrences have proven extremely challenging to me there were also others which fell into place without me pushing the matter, and some that totally blew me away.  Achieving compliance has definitely shaped my placement journey and as result, myself as a practitioner.

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Presenting Friday 7th December in 4pm-5pm session.

Emma Waterham

Small Victories

At the start of our final year it was hard not to be overwhelmed while learning the underlying theory behind countless clinical conditions. Next came selecting and delivering the best objective test or exercise (with an examiner a metre away staring into your soul), followed by figuring out how to navigate complex funding schemes … all of this while attempting to master the mystical ‘biopsychosocial approach’. But somewhere in the blur of all this new information, along with worrying about being a good EP and getting a job, was sheer excitement about being part of an industry that is built on improving peoples’ quality of life.

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As exercise physiologists we are in the business of helping people, and needless to say there is a part of all of us who would love to change someone’s life for the better. This was the sparkling gem hidden within the gigantic mountain of all that studying, but going on placement completely transformed how I picture achieving this goal. This presentation is about a handful of case studies that taught me that everyone’s idea of a challenge, and hence what they deem a success, is all relative and that it’s not one spectacular life-changing event, but rather a collection of small victories that make the most impact on the people we work with.

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Presenting Saturday 8th December in 11:15am-12:30pm session.

Grace Lane

Exercise Physiology and Autism

The importance of increasing physical activity in the Autism spectrum disorder population is widely supported by research and cannot be overlooked. It is largely accepted that the benefits of early intervention with children with ASD is beneficial, however this is a sector mainly dominated by Occupational Therapist. So the question is “where can we as Exercise Physiologist fit into this equation and make a major impact in improving the lives of people living with ASD?”

ASD is a complex neurodevelopmental condition typically diagnosed in childhood and lasts a lifetime. The main areas of difficulty are in social communication, social interaction, restricted or repetitive behaviours and interests, and deficits in gross motor skills. The diagnostic rate of ASD has increased since the turn of the century, predominantly due to it being more easily recognisable as a result of increased awareness and research.  This increase is portrayed by the number of people who were previously living undiagnosed that are now being diagnosed in early adulthood. This is resulting in a greater population requiring exercise intervention strategies.

Associated with this group is an increased risk of co-morbidities including type 2 diabetes, cardiovascular disease, obesity and some types of cancers. Alongside these health risks,  functional gross motor deficits such as low muscle tone/strength, poor stability, low endurance, compensatory movement patterning and poor gait affects participation rates and integration into society. Therefore, a demand is in need for increasing the scope of exercise prescription in order to promote a physically active lifestyle.

When working with this population it is fundamental to have an understanding of the characteristics and behaviours often encountered. I will further discuss relatable clinical examples of behaviours faced to further our understanding of people with autism and our importance as Exercise Physiologists to this population.

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Presenting Friday 7th December in 4pm-5pm session.

Harold Gathercole

Trying to be effective, an hour per week

What is it that I can do, in this moment, to maximise outcomes for this person? As exercise physiologists we are acutely aware of the fact that we see our clients for somewhere between one-half to two percent of their waking hours, and that’s for the regulars, with decent sleep quality. 

I have been lucky to have diverse placement experiences this year. Starting off with an (almost) captive population at Flinders, I quickly learned where I fit in and how I could be most effective in contributing to a patient’s rehabilitation process.

At least that’s what I thought. Self-concept is a funny thing, and throughout the year various successes in particular have challenged mine. My time in private practice expanded my perception of effective intervention to include less concrete… dare I say… soft skills.

This presentation will attempt to discuss my evolving concept of what it means to be an effective practitioner, and I will recount some of the small, but defining moments of my placement experience, and how these have led me to strive to become a more complete clinician.

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​Presenting Saturday 8th December in 11:15am-12:30pm session.

Jack Elsworthy

Pain sucks: Improving the lives of people in Pain

Pain sucks – many of us have, and will, experience it over our lifetime. Despite spending four painstaking years learning about the biopsychosocial model and the all-encompassing nature of pain, it wasn’t until during my placements that I began to understand its implication. The complexity of pain, especially persistent pain, can only be truly comprehended through being exposed to real life practical experience. It was throughout my placement journey that my perspective shifted regarding pain and it opened my eyes to the many harmful beliefs and misconceptions of others.

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What a great position we are in as a profession to be able to consider the whole person and in particular, the dynamic and multifaceted nature of persistent pain.  Let’s take the challenges of our relatively new healthcare profession, where people typically don’t know what to expect when they present at our consults and use this as an opportunity to embrace a holistic approach and work with people to improve their function and quality of life.  

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This presentation will uncover my experiences working with people in pain within a healthcare system that incentivises the quantity rather than the quality of healthcare services. It will delve into pain education and the important role we play as Accredited Exercise Physiologists in improving the lives of people in pain and promoting the role of our profession.

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Presenting Friday 7th December in 2:45pm-3:45pm session.

Joshua Beagley

Lessons learned on placement which University doesn't teach

Pathophysiology, medications, contraindications, guidelines and objective measures. My final year of course work provided so much content regarding different conditions and how to treat and manage them. However, through starting my placement experience, I was hit with the hard reality that although I had completed all the course content, there was still so much more to learn.

This presentation will discuss lessons which I learned throughout my time on placement which are not taught at university. These lessons have helped in the development of myself as an exercise physiologist and have changed my outlook on the profession and my approach to clients.

The presentation will introduce cases I have encountered during my time on placement this year, through which I have developed a greater understanding of considerations such as the differences of our services between individual clients, the importance of client self-management, and the necessity to never assume just how much or how little a client can do. I will explore the means through which I have learned these lessons in my practice, as well as some cases I would now approach differently had I known these things before.

My experiences this year on placement have not only confirmed that this amazing profession is one in which I am excited to pursue a career. It has shown me how versatile our practice can be and how we are much more than individuals who prescribes exercise.

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​Presenting Saturday 8th December in 11:15am-12:30pm session.

Karen Winters

Exercise Prescription using Heart Rate Variability (HRV)​

We are more alike, my friends, than we are unalike.

—Maya Angelou—

In her poem, Human Family, Maya Angelou wisely points out that despite incredible diversity in the world we all have more in common than we do differences.  We divide our placements into apparently healthy and clinical placements for the purpose of our studies.   We leap into 4th year, excited to now work with clinical populations and increase our knowledge of chronic conditions.  Despite the differences and challenges individuals face we do fundamentally have more in common. 

During my placement at Adelaide Exercise Physiology I observed how Heart Rate Variability (HRV) was used to guide exercise prescription.    HRV is a measure of autonomic system function and in the clinic it was being used to assess daily exercise capacity for clients with conditions such as Chronic Fatigue Syndrome (CFS).  However I was also able to observe how athletic populations were able to use HRV to inform training to increase performance and avoid overtraining syndrome.  

During my presentation I will briefly overview what HRV is and how it can be used in the clinic with both clinical and athletic populations.

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Presenting Friday 7th December in 4pm-5pm session.

Katie O'Brien

EP support for mental Health: the power of human connection

An Exercise Physiologist (EP) can play an important role in helping to manage mental health. This is not only through safe and appropriate introduction of more movement into an individual’s life, but as I’ve seen during placement, also through the power of human connection.

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Almost half of all Australians will experience a mental illness in their lifetime. Exercise, has been shown to have significant potential in positively affecting the life of someone suffering with a mental health disorder – both physically and mentally. A supportive, individualised, evidence based exercise program delivered in a supervised setting can have such positive outcomes.

Amongst many barriers to participation in this population, lack of support has been noted as a key barrier. It has been reported that many patients feel exercise supervision would enable them to exercise more and that this is important to long term adherence.

The importance of this support and the consideration of mental health for every client has become evident to me during my time on placement. This presentation will highlight that part of this support, along with the importance of safe exercise prescription and delivery, comes down to human connection. One client, experiencing anxiety and depression, highlighted this to me in expressing sincere gratitude for being treated as more than “a hip or a knee”.

The support of an EP – built on genuine human connection when an individual feels heard and respected – to find more movement, can be hugely powerful in positively impacting the mental health of every client.

Maddy Halton

Remembering the Importance of Exercise for Dementia Clients.

Dementia. Defined by a group of diseases that are fast progressing and associated with a loss of memory, intellect, rationality and physical function.

Dementia Australia (2018) estimates that by 2025 as many as 318 people per day will be diagnosed with a form of Dementia. 318 Grandparents, Parents, Sons, Daughters, Brothers and Sisters per day. Despite being most common in individuals over 65, early onset dementia can begin to rear its head as young as 30.

This presentation will focus on the varying levels of Dementia and the highs and lows of working with this population as an Accredited Exercise Physiologist, particularly in the aged care sector. The role of an Exercise Physiologist in the lives of Dementia sufferers and their families is not only beneficial but important. Exercise intervention has the potential to improve physical function and slow the rate of cognitive decline, but it can also bring quality of life, despite the symptoms associated with Dementia.

My experience working with Dementia clients whilst on placement this year has not only given insight into the highly variable challenges of working with this population but has also been a massive learning curve for me as a budding Exercise Physiologist. It has sparked an interest in a condition that I did not know much about or even fully understand previously, and I hope to further my knowledge and skills working with this population in future. This presentation will include some key case studies I encountered throughout my placement.

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Presenting Friday 7th December in 4pm-5pm session.

Marta Macris

Focus on their ABILITIES not the disability. A comparison of how exercise prescription differs with adolescents v adults with disabilities.

I was fortunate enough to experience two interesting cases of clients with cerebral palsy, one being a 16yo female spastic hemiplegic at the MBHS disability unit, and the other a 60yo female spastic quadriplegic at AEP. This has inspired me to discuss how exercise prescription and delivery can differ between people with the same condition, the challenges that come working with them, and the important role exercise can have for those with physical and intellectual disabilities.

Both clients had similar goals, which focused on improving LL strength and mobility aimed at improving their walking gait and participation in ADLs. The exercise prescription did differ between the two clients, whereby the 16yo had no walking aids or issues with transfers, compared to the 60yo who required a seated program. The challenges amongst the two clients were quite different. In regard to the 16yo, this was due to her intellectual disability and behavioural issues, whereas for the 60 yo it was due to her physical capabilities and medical history making exercise prescription challenging. At the end of the day, I came to a realisation that despite the challenges I faced, and how their prescription differed, exercise was about disregarding their disabilities, looking at their abilities and helping them strive to their goals.

 I believe that all people with a disability whether they are young or old, should have the aspiration to be great at something, and participate in as much exercise as possible in a fun and engaging manner.

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Presenting Friday 7th December in 2:45pm-3:45pm session.

Megan Wheatley

One student, one patient, two teachers 

Picture this. A nervous fourth year Clinical Exercise Physiology student enters her first clinical placement at Flinders Medical Centre. A ball of nerves and not entirely sure of what exactly was going on.

The first patient she meets is a 60 + year old female with a hip replacement, embarking on her first structured exercise session and equally unsure of the process.

That was Belinda and I*.

This presentation will discuss the trials and tribulations of a nervous student, nervous patients, building rapport and discovering how much of an impact you can make when you understand that patients are far more than just their conditions.

Sometimes the little things make the biggest difference, whether that be remembering someone’s name, asking how someone’s going or just offering a friendly smile. My journey with Belinda started as a mutual bond over a fear of the hard work, learning and exercises to come. It ended with a far stronger hip and an understanding of the privilege we have to make such a difference in someone’s life.

The biggest thing I’ve taken away from my clinical placements is that whist clinical reasoning and EBP underline our practise, rapport and trust allow use to make the biggest difference to the biological, psychological and social health of a person.

*not her real name

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Presenting Friday 7th December in 2:45pm-3:45pm session.

Sam Taylor

My rural placement experience

After a long 7 hour drive I arrived in the country town of Port Lincoln, my home town. Residents like to argue that its now classified as a city, but for the purpose of my placement block, it was well and truly a rural placement experience. Exercise Physiology has only recently been introduced to Port Lincoln, as it has to many other country towns around South Australia, with countless people now having a service they thoroughly deserve.

This presentation will focus on my time spent in Port Lincoln, exploring both the good, and the frustrating experiences of practicing as an Exercise Physiology in a rural area. Despite it only being 5 weeks, I was able to see first-hand just why exercise physiology is a much-needed service in more remote areas.

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​Presenting Saturday 8th December in 11:15am-12:30pm session.