What Is the Scope of Practice?

updated: 2019-04-02

Disclosure: The practice of kinesiology varies from one province to another. The information in this document may differ and not correspond with the provincial legislation. The main purpose of this document is to present the current portrait of kinesiology (definitions, fields of practice, acts, etc.) across Canada, with information regarding resources in the various fields of kinesiology, practical tools, the extent of its scope of practice, and other potentially useful information. This document is in perpetual revision as per the evolution of the practice of kinesiology in Canada. The CKA / ACK will not be held responsible for any consequences or damages that may occur as a result of the use, misuse, misinterpretation, or abuse of the information found on its website. We emphasize that the aim of this document is to help guide you. Should anyone require guidance in interpreting any of the provided information, they should seek the advice of their provincial kinesiology association.

KINESIOLOGY IS ALL ABOUT HOW WE MOVE

Kinesiology is the study of the dynamics[1] of human movement, including all the components involved (anatomical, physiological, neurological, biochemical, biomechanical, neuromotor, psychological), as we interact with our environment. Kinesiology is also defined as human kinetics, or the scientific study of how we move. The term is derived from the Greek kinesis, to move.

 

Kinesiology includes the following fields of study:

• Physiology
• Biomechanics
• Neurology
• Mobility
• Anatomy
• Psychology
• Sociology
• Posturology
• Anthropometry

In Canada, these different fields are grouped together under the kinesiology umbrella, focusing on all aspects of human locomotion.

 

Kinesiologists work with people of all ages and physical abilities, in many settings, to help them achieve their health and wellness goals. Kinesiologists work with:

• Students
• Adults
• Seniors and the elderly
• Pre- and post-natal clients
• Military personnel
• Athletes
• Children
• Employees
• Anyone with or without pathologies and symptoms

Kinesiologists help improve quality of life, often using interventions that include physical activity.

 

Kinesiology interventions are varied and target all Canadians, regardless of age and whether or not they are affected by health problems. Kinesiologists work in:

• Municipalities
• Research organizations
• Private and public educational institutions
• Fitness centres
• Military and public security organizations
• Community groups
• Outdoor organizations
• Athletic organizations
• Public and private organizations
• At-home interventions
• Public and privately managed centres
• Public and private rehabilitation clinics
• Government health facilities
• Insurance companies

 

TARGET CLIENTELE

 

ASYMPTOMATIC (WITHOUT SYMPTOMS OR PATHOLOGY)

• Adults in general, including pregnant women
• Specific clienteles (including paramilitary and military services, employees, astronauts)
• Athletes and adventurers
• Children and adolescents
• Students and student athletes
• Seniors and aging populations

SYMPTOMATIC AND WITH CLINICAL CONDITIONS

• Metabolic conditions
• Cardiovascular conditions
• Pulmonary conditions
• Neurological conditions
• Musculoskeletal problems
• Mental health and psychiatric diagnoses
• Other conditions (including chronic pain and sensory disorders)

The health and physical activity needs of any client encompass many factors. For this reason, an interdisciplinary and collaborative approach generally ensures a superior level of service. Kinesiologists often collaborate with other health professionals to develop multidisciplinary and interdisciplinary intervention, prevention, and treatment plans. They also support medical teams in evaluations and are involved in enhancing performance, including sport performance.

 

Kinesiologists complement other health care professionals with the wide range of their knowledge and broad scope of their practice. Here are some examples of what a Kinesiologist can bring to the team:

• Prevention, promotion, treatment, and rehabilitation services to various health facilities, including mental health clinics and private clinics
• Neuromusculoskeletal and functional evaluations
• Ergonomics in workplace and occupational health cases
• High-performance coaching and fitness training
• Public health promotions
• Clinical management and coordination
• Case management for insurance companies
• Personal training and physical condition coaching
• Researching
• Lecturing, instructing, and teaching
• Promotion of physical activity and adopting healthy and physically active lifestyles

Kinesiology is an evolving profession, continually adapting to changing client needs.

 

COMPLEMENTARY TRAINING AND SPECIALIZATION

The initial bachelor’s degree in kinesiology can be the basis for additional training, specialization, or a different professional practice. All training or specialization must meet the standards of the province you wish to practise in. Treatment methods are not regulated the same way in all provinces. The CKA recommends that you check with your provincial kinesiology association to see what services you can legally provide before you make any decisions.

• In some provinces, additional training in kinesiology may allow you to offer other services like occupational therapy. In other provinces, occupational therapy is a regulated profession and requires specific and exclusive training. In those provinces, you cannot legally provide occupational therapy or ergotherapy without being a member of the college or order.
• Provincial kinesiology associations have the right to restrict the scope of practice in their province. In some provinces, for example, Kinesiologists also have to be registered osteopaths if they wish to practise osteopathy. In some provinces, the same applies to Kinesiologists wishing to use manual therapy techniques.

 

WORKING WITH OTHER HEALTH CARE PROVIDERS

Kinesiologists respect the expertise of their health partners. In areas beyond our scope of practice, we always refer clients to the appropriate accredited health care professionals. Kinesiologists are able to provide basic advice on related subjects (like nutrition) based on their initial level of education. However, education and acquired competency in their own field of practice are not sufficient to incorporate all the nuances required to target specific needs. It can happen that the conveyed information, though exact and provided in good faith, can be unsuitable for a particular client. This is why we prioritize interdisciplinary and multidisciplinary work and refer clients to the appropriate health care expert whenever necessary.

For a list of the scope of practice of a clinical exercise physiologist and a Kinesiologist affiliated with the CKA (acts that are performed by one but not the other, and by both), consult this document.

 

THE STEPS TO INTERVENTION

Kinesiologists are specialists in the dynamics of human movement and its components. The primary means of intervention is physical activity. The scope of the practice and underlying actions are based on a wealth of science-based evidence that touches on prevention, fitness, rehabilitation, education, and performance.

Here is a list of the steps to intervention. Details of the steps can be found in this document. 

THE ASSESSMENT

• The search for pertinent information
• The initial or motivational interview
• Identification of the intervention mandate
• Choosing protocols and administering tests
• The analysis (interpretation of results)

 

THE INTERVENTION PLAN (PRESCRIPTION AND INTERVENTION)

Based on the results of the assessment, an intervention plan is executed with the following components:

• A physical activity program
• An exercise program
• An interdisciplinary intervention plan (e.g., job demands analysis, education programs, ergonomic assessment)
• A physical preparation plan for athletic performance or other objectives

 

Execution requires appropriate professional supervision, with a critical focus on the Kinesiologist’s intervention and an ongoing readiness to adjust the program in order to optimize the achievement of the client’s objectives while minimizing any risk of harm.

Professional intervention can begin at any time before, during, or after primary, secondary, or tertiary prevention, alone or in conjunction with a multidisciplinary team, in a medical or sport performance situation. In addition to clinical intervention, Kinesiologists also provide consulting expertise to facilitate the adoption and reinforcement of healthy lifestyle habits.

 

THE INTERVENTION

During an intervention, the following tasks may differ depending on the sector and the clientele.

Groups

• Execute the intervention plan and carry out the mandate within group activities
• Respect the principles of a personalized approach even in the context of a group activity
• Teach an aerobics or strength training class
• Provide instructions on techniques to safely and effectively execute given movements
• Teach clients the names of muscles and cardiovascular systems used during the activities
• Correct techniques in movements
• Oversee functional training
• Motivate a group in pursuing their goals
• Provide educational sessions on healthy lifestyle habits
• Present conference sessions
• Teach pain management strategies
• Collaborate with community organizations to promote physical activity
• Organize activities
• Teach prevention and rehabilitation programs
• Establish tools adapted to train supervisory staff, employees, and other stakeholders
• Coordinate and co-host committee meetings
• Advise institutional administrators on policies, programs, and action plans that reflect sound lifestyle management to help improve performance

Individuals

• Execute intervention plans and carry out mandates
• Respect the principles of a personalized approach
• Supervise clients in individualized training or during rehabilitation process
• Supervise clients in training area or in any other significant physical activity
• Adjust or modify the intervention plan over the course of its execution
• Promote an active lifestyle
• Teach pain management strategies
• Follow up on client training, recovery process, fitness, and lifestyle habits
• Motivate clients in pursuing goals
• Perform activities
• Develop motor skills and physical abilities
• Advise stakeholders (production, human resources, employees, unions) in order to identify and minimize the risks of work-related accidents and occupational illnesses

 

Within the intervention plan, Kinesiologists are called on to perform a number of tasks related to prescription and intervention depending on the setting or environment. They must always act ethically and responsibly throughout the process while maintaining a critical eye on their intervention.

 

THE KINESIOLOGIST’S DEGREE OF AUTONOMY

Kinesiologists have full autonomy in using their clinical judgment to carry out their professional tasks competently and with integrity, particularly during evaluation, prescription, and intervention processes, regardless of the setting or environment. Their judgment is not used to make a medical diagnosis, but rather to identify the starting point of their interventions in meeting obligations to clients. In some provinces and in some of their practice settings, Kinesiologists interact with colleagues in the health care field as part of an interdisciplinary framework. But even in this context, they have unequivocal and decisive autonomy in the execution of their professional tasks. Kinesiologists may also be asked to perform tasks that are not directly related to their profession, including management (administration, disability, health and safety), coordination (of a clinical team, with an insurer), research, and health promotion.

 

Kinesiologists must be the only signatory on their evaluations. General and direct supervision is an intradisciplinary process, and Kinesiologists are solely responsible for their position or professional opinion, even in a medical context. The physician is the one who issues a medical prescription and specifies the restrictions. The physician remains in charge of the medical process, but the Kinesiologist retains responsibility for their own actions within the limits of their competencies and legislative restrictions.

 

The scope of the Kinesiologist’s practice may vary from province to province depending on initial training, permitted supplemental or ongoing professional development, and existing legislative framework. For example, while manual therapy, manipulations, and osteopathic techniques are not recognized as part of the kinesiological practice in Quebec, they are recognized in other provinces. That’s why it’s important to check and seek advice on specific applications and provincial legislation by contacting your provincial kinesiology association or the CKA.