Prescriptive Exercise - Your Doctor writing a perscription for you to attend indoor cycling classes

How cool would it be if your insurance company paid for indoor cycling classes?

A national policy of Prescriptive Exercise would be the holy grail* for small studio owners. 

Imagine; A new client walks in with her doctor specified exercise regimen for you to "fill", just like at a pharmacy. As an approved provider, you and your studio would provide the required exercise and then bill the clients insurance company... and not at your normal class rate - at a much higher rate in recognition of your fitness expertise.

A fantasy? Nope**, not if you're near The Wellness Institute in Winnipeg Canada. Doctors there are actually writing detailed prescriptions for exercise. How cool is that?

Prescriptive Exercise - Your Doctor writing a perscription for indoor cycling classes

Winnipeg doctor Kevin Saunders writing prescriptions for exercise

Doctors at a unique medical facility in Winnipeg are starting to write some unusual prescriptions.

"A lap a day keeps the doctor away" is one of the mottos at the Seven Oaks Wellness Institute (SOWI), a fitness facility attached to the Seven Oaks General Hospital on Leila Avenue, where doctors have started prescribing exercise instead of pills.

Dr. Kevin Saunders is one of the founders of the SOWI and the medical director. He said exercise is an effective treatment for all kinds of illnesses, including hypertension, Type 2 diabetes, high cholesterol and even some forms of cancer.

The facility offers clients a more holistic approach to fitness, helping people from all walks of life to understand what kinds of exercise they should be doing, and what they need to avoid if it puts their health in jeopardy.

You'll note that what Dr. Sanders is targeting with this program are Special Populations of people who would benefit from physical activity. I'm guessing you'd have a little trouble getting a prescription for a USAT Triathlon coach to get you ready for your next Ironman 🙂

What has me most excited here is the potential for prescriptive exercise for people suffering from Parkinson's Disease. It's been shown repeatedly that people of all ages with PD respond well to Indoor Cycling classes. Especially classes that are designed and taught by a Parkinson's Cycling Coach. Indoor Cycling studios already have the necessary tools to conduct this hugely beneficial classes. They're best held around 10:30 - 11:30 in the morning, which is normally a time without a scheduled class

I did some research and found an excellent article here at emedicine.medscape.com that explains in detail what Perscriptive Exercise is (different from physical rehab) and includes a number of areas where exercise is typically prescribed by a physiian.

Background

Exercise prescription commonly refers to the specific plan of fitness-related activities that are designed for a specified purpose, which is often developed by a fitness or rehabilitation specialist for the client or patient. Due to the specific and unique needs and interests of the client/patient, the goal of exercise prescription should be successful integration of exercise principles and behavioral techniques that motivates the participant to be compliant, thus achieving their goals.[1, 2, 3, 4, 5, 6, 7]

Components of exercise prescription

An exercise prescription generally includes the following specific recommendations:

  • Type of exercise or activity (eg, walking, swimming, cycling)
  • Specific workloads (eg, watts, walking speed)
  • Duration and frequency of the activity or exercise session
  • Intensity guidelines — Target heart rate (THR) range and estimated rate of perceived exertion (RPE)
  • Precautions regarding certain orthopedic (or other) concerns or related comments

Note that a properly structured, Power based Indoor Cycling class would easily include all of the stated components.

Consider this simple prescription:

  • Type of exercise or activity - Indoor Cycling class.
  • Specific workloads - Below, @ and Above riders observed 4 minute Best Effort PTP Watts or FTP if known
  • Duration and frequency of the activity or exercise session - 3 x 60 min classes weekly
  • Intensity guidelines — each 60 class to include: 5 x 5 min intervals @ PTP, 3 x 1 min intervals Above PTP, that remainder of class Below PTP and Above VT1 (staying aerobic) + adequate recovery after each @/Above interval.
  • Precautions - None

What you'd have is essentially an endurance training program, written by an MD.

Taking this further. If you were to incorporate the rider's performance data capture, from a Display Training system like Performance IQ or Spivi, your doctor could review your progress = make informed recommendations for future exercise prescriptions. Wouldn't that be awesome?

If you can offer any additional information about prescriptive exercise, I'd love to hear from you!

*Yes, I'm aware that many insurance programs offer a discount/rebate for club dues - if you attend a speciaf number of days a month. This is very different.

** I don't know the specifics of Canada's reimbursement system, but I'm looking into it. I have asked for a representative join me on the Podcast to discuss all of this.

John

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