2. What can an Exercise Physiologist do for you? Help to manage chronic conditions with lifestyle and behavioural change. Many Chronic conditions can be positively effected by particular evidence based physical activity.

3. For example Type 2 Diabetes Mellitus – Strength training produces a “contraction mediated glucose uptake” (glut4 translocation) into the cell without the presence of insulin. This effect can last up to 72 hours (Tresierras & Balady, 2009). Weight loss reduces intra- muscular fat that is responsible for reduced insulin sensitivity (Hordern et al., 2012).

4. Cancer – Cancer cachexia sees the rapid reduction of muscle mass. Research shows that exercise can benefit by slowing this process and even building lean body mass (Ardies, C. M. (2002). There has also been evidence that moderate-intensity exercise can improve immune response through an increase in the number of T helper lymphocytes, Interleukin-2 receptors and the priming of neutrophils. The increase in IL-2 cytokine and its receptor initiates the proliferation of T helper cells thus enhancing the immune response (Broadbent & Gass, 2008; Lancaster et al., 2004; J. Woods et al., 1999)

5. Other conditions that are positively effected by physical activity Musculoskeletal – Arthritis, Sub-acute or chronic injuries, Orthopedic pre/rehabilitation, Osteoporosis. Pulmonary – Asthma, COPD Cardiovascular - Chronic Heart Failure, CAD/PAD - PCI/CABG post surgery, Hypertension Metabolic – Hypercholesterolemia, Dyslipidemia, Impaired glucose tolerance, Obesity Neurological/Neuromuscular – Stroke, SCI, TBI, Parkinson’s, MS, Cerebral Palsy, Muscular Dystrophy, Neuropathies Mental health – Depression, Bipolar Aging – Managing functional capacity, Falls prevention.

6. Time line of Exercise Physiology service through Enhanced Primary Care Plan (EPC) Start – Session 1 initial consultation and assessment, relevant testing, barrier identification, stage of readiness and initial activity program. Noting the need for referral to other allied health providers. Report to GP. Approximately 2 weeks – Session 2 individualised evidence based exercise program. Evaluation of adherence to intervention.

7. Approximately 4 – 10 weeks – Session 3 and 4 accountability check and support, progress and modify physical activity program as required. Approximately 12 weeks session 5 – final session review of action plan and health outcomes, aim for self management of physical activity and increased incidental activity. Report to GP with outcomes and recommendations with regard to further lifestyle interventions.

8. Under Medicare Item 81110-81115 People with Type 2 Diabetes mellitus can access one initial consultation and 8 group exercise sessions. Item 81315 People of Aboriginal and Torres strait Island decent can access 5 1 on 1 allied health sessions These are on top of EPC item 10953 consisting of 5 allied health visits.

9. You can also claim Exercise Physiology through Department of Veterans Affairs Private Health Insurance

10. We offer 1 on 1 care in consulting rooms (including home visits) Group classes with individualised programs Group circuits Access to subsidised Move2change program

11. Mark Roberts ESSAM ACEP M.CEP, BSc (ExSc) revolutionfitness.vpweb.com.au revolutionfitness.vpweb.com.au mrob67@bigpond.net.au Po Box 8080 Dunoon 2480 0419831424/0266895950 r evolution Fitness n. Fundamental Change Dynamic Health Solutions Jason Mickan ESSAM AEP BEXSCINUT Po Box 99 Byron Bay NSW 2481 Jasonmickan@aapt.net.au 0421932959