From education to innovation: LJMU shaping the future of clinical exercise physiology 

For many people living with multiple long-term health conditions, being more active can make a real difference to their health, independence and quality of life. But knowing what exercise is safe and appropriate can be challenging, particularly when someone is living with several health conditions at the same time. 

This is where Clinical Exercise Physiologists (CEPs) can play an important role. 

CEPs are healthcare professionals who specialise in using exercise to help prevent, manage and rehabilitate health conditions. They combine specialist knowledge of exercise with an understanding of health and disease, allowing them to develop safe and personalised exercise programmes for people with complex health needs. 

At Liverpool John Moores University (LJMU), researchers and healthcare professionals are helping to demonstrate how this emerging profession can become an integral part of modern healthcare. 

Bringing clinical exercise expertise into the community  

The LJMU Clinical Exercise Physiology Clinic provides free, personalised exercise support for people living with long-term health conditions. The service is delivered by registered CEPs and supports people at different stages of their health journey; from becoming more active and improving overall health, to preparing for surgery and rebuilding strength following illness or treatment.

What makes the service particularly innovative is that it is also a student-led clinical service, creating a unique learning environment where education, clinical practice and research come together.

Under the supervision of experienced and registered Clinical Exercise Physiologists (CEPs), students gain valuable hands-on experience working with real patients and applying their learning in a clinical environment.

The service provides practical training opportunities for BSc Sport and Exercise Science undergraduates, helping them develop their understanding of exercise assessment, communication and professional practice, while also providing advanced clinical experience for MSc Clinical Exercise Physiology students undertaking the AHCS-accredited programme at LJMU. 

The clinic offers personalised assessment and exercise programmes, alongside one-to-one professional support and flexible options for exercise delivery. An online service also provides access to specialist CEP support for people who may find it difficult to attend appointments in person.

The CEP clinic delivers benefits beyond the individual patient to support both individual patient care and wider service needs. Healthcare professionals can direct individual patients to the service, while GP practices and wider health and care organisations can also explore group access for patients with shared health needs.

The CEP clinic provides a real-world training environment for the next generation of exercise and clinical exercise professionals, while generating valuable experience and evidence to inform the future development of CEP services.

But LJMU's ambition goes beyond providing a clinical service. The University is also exploring how CEPs can become an integral part of the wider healthcare system – including within primary care – and how their specialist expertise can complement existing healthcare teams to improve prevention, rehabilitation and the long-term management of health conditions.

A new model for primary care  

Working with Central Liverpool Primary Care Network (CLPCN), LJMU has developed an innovative CEP-led service within primary care, supported through an Innovate UK Knowledge Transfer Partnership (KTP). 

The partnership is exploring how specialist exercise expertise can be integrated into GP practices to support people living with multiple long-term conditions. Rather than asking patients to navigate multiple services, the CEP is part of the PCN delivery team and can provide an individualised assessment and exercise prescription that takes account of the person's health, abilities, confidence and goals.

Attending the Clinical Exercise Physiology sessions has had a positive impact on both my physical and mental wellbeing. Since starting the programme, I’ve noticed improvements in my fitness, confidence, and overall health. The guidance and encouragement, from both the staff and students, has helped me achieve steady progress.

I’ve gone from being unsure where to begin with exercise to feeling confident and capable of exercising safely and independently with minimal support. The flexible nature of the sessions, along with the small group environment, has created a welcoming and motivating atmosphere that has helped me stay engaged and committed to improving my health.

Cathy Pepp
CEP Clinic participant

The CLPCN service currently provides a six-month programme of support for eligible adults living with two or more conditions such as COPD, hypertension, type 2 diabetes, heart failure, arthritis or fibromyalgia. It can also support people following cardiac or pulmonary rehabilitation and those preparing for or recovering from hip and knee replacement.

This represents an important shift: bringing specialist exercise expertise closer to where people live and receive their everyday healthcare.

From innovation to NHS impact  

The work is particularly timely as healthcare systems look for new approaches to prevention, rehabilitation and the management of long-term conditions. CEPs have the potential to complement existing healthcare teams, helping people use exercise as part of their overall treatment and supporting them to remain active and independent.

The team from LJMU is also contributing to the wider development of the profession with Clinical Exercise Phsyiology UK. Clinical Exercise Physiology is now established within the UK's healthcare science framework, with CEPs eligible for registration through the Academy for Healthcare Science (AHCS). Professional standards, a defined scope of practice and an accredited MSc curriculum provide a framework for safe and high-quality clinical practice.

For LJMU, this combination of research, education and real-world healthcare delivery provides a unique opportunity to test new models of care and generate evidence that can inform wider NHS adoption.

Our work highlights not only the growing role of Clinical Exercise Physiologists, but also what can happen when universities, healthcare professionals and NHS organisations work together to develop new solutions to some of healthcare's biggest challenges.