We were asked recently, “What is a medical device company doing wasting its time with the fitness industry?”. The question is easy to answer, we are not. The more interesting presumption behind the question is that the medical industry and the fitness industry are incompatible. In the past, this may have been true, and it is still true today that many doctors are suspicious of the fitness industry. What is also true is that if physical activity is part of the solution for preventing an increasing pressure on health budgets, the medical and fitness industries will be working more closely together.
The medical industry is used to provide extremely accurate diagnostics before treatment is prescribed or delivered. Checks and balances to ensure patient safety are present throughout. It is this level of rigour, accuracy and professionalism that the fitness industry needs to demonstrate to work alongside health professionals effectively.
In our recent blog, ‘MIE – Measurement is Evidence’, we discussed what you measure in fitness so now let’s look at how you measure it with the same accuracy as the medics are used to.
The American College of Sports and Exercise Medicine (ACSEM) has a model for fitness that involves six key parameters. They say that to accurately assess fitness you should assess muscular strength, muscular endurance, cardiorespiratory endurance, neuromuscular control, body composition and flexibility. The methods and gold standards for these in most parts exist. For example, DEXA is the gold standard for body composition but as this involves radiation it is impractical for gym use. Bioelectrical Impedence Analysis (BIA) has become the closest proxy for body composition for in-gym use. There are several providers of BIA technology for use in gyms so measuring body composition is well covered. For the other areas in the ACSEM model, it is not so easy.
For professional athletes, there are solutions for measuring muscular strength and endurance. Isokinetic machines have long been used for absolute strength measurement. They are also used to measure muscular endurance by measuring the precise changes in time from one rep to the next over a long period of time. However isokinetic machines are way beyond most gyms as they cost circa £50,000 each. At FitQuest we measure forces in a similar way by precisely measuring the forces an individual can exert with each part of their body. By making measurements every 1000th of a second we can measure the time taken for each rep or step precisely. Research shows that for most (except elite athletes and special forces) 15 seconds is all that is required to observe tiny changes in these times and therefore, calculate what is happening to muscular performance.
For neuromuscular control measurements bio mechanists have the Lab. Biomechanical labs with force floors or fully instrumented treadmills are expensive things to build but provide a variety of methods for measuring neuro-muscular control. FitQuest provides a gym user with their own mini biomechanical lab. We use exactly the same technology and software that is used in the lab with an interface designed to make it easy for people to interpret, without needing a background in biomechanics.
Medics and elite athletes will always use VO2 max as the cardiovascular endurance measure of choice, but it is simply not practical in the gym setting for the mass market. Doctors will agree that a simple cardio recovery test is a good enough proxy for 98% of the population. FitQuest measures heart rate recovery after a user has completed the speed endurance test to measure cardiovascular fitness, providing accurate information within 60 seconds.
Of the ACSEM factors it is only flexibility that cannot be measured easily today. There are products like MIE’s goniometer which can measure movement precisely, but there are no defined standards for what is good and bad for each sector of the population. This is because in any given sport there is no correlation between flexibility and medal winning potential. As a result, it has not been subject to detailed research like the other factors by leading sports science schools in the world. However, the interest in loss of flexibility in the older population and active ageing does mean leading medical universities are beginning research in this area. It is only a matter of time therefore, before standards for measurement are set.
So, where does this leave the medical community and the fitness industry. The Chief Medical Officers of England, Scotland, Ireland and Wales have published an infographic based on earlier papers.
It has a set of very simple measures, sit less, be active including cardiovascular and strength training, and improve balance for long term health benefits. Now, if the fitness industry can measure these components with the accuracy and scientific rigour that is the norm in the medical world, it goes some way to filling the gap in evidence that demonstrates these facilities can provide a significant contribution to improving the health of the nation. FitQuest enables the industry to build this evidence database quickly and easily without the need for extra staff or significant training.
If we consider research being carried out today in universities around the world; for example, connections between changes in grip strength and cardiovascular risk, strength and risk of falls in older people, balance and early detection of diabetes or drug change issues; then the collaboration between the fitness industry and the medical world is likely to grow as long as the fitness industry can measure well.
It is for this reason, we at MIE do not believe working in this field is ‘wasting our time’ and look forward to a long and happy relationship with the fitness industry to make a positive difference to millions of people’s lives.