Competitive swimming requires multiple bouts of high-intensity exercise, leading to elevated blood lactate. Active exercise recovery has been shown to lower lactate faster than passive resting recovery but may not always be practical. An alternative treatment, electrical muscle stimulation, may have benefits similar to active recovery in lowering blood lactate but to date is unstudied. Therefore, this study compared submaximal swimming and electrical muscle stimulation in reducing blood lactate after sprint swimming. Thirty competitive swimmers (19 men and 11 women) participated in the study. Each subject completed 3 testing sessions consisting of a warm-up swim, a 200-yard maximal frontcrawl sprint, and 1 of 3 20-minute recovery treatments administered in random order. The recovery treatments consisted of a passive resting recovery, a submaximal swimming recovery, or electrical muscle stimulation. Blood lactate was tested at baseline, after the 200-yard sprint, and after 10 and 20 minutes of recovery. A significant interaction (p < 0.05) between recovery treatment and recovery time was observed. Blood lactate levels for the swimming recovery were significantly lower at 10 minutes (3.50 +/- 1.57 mmol.L-1) and 20 minutes (1.60 +/- 0.57 mmol.L-1) of recovery than either of the other 2 treatments. Electrical muscle stimulation led to a lower mean blood lactate (3.12 +/- 1.41 mmol.L-1) after 20 minutes of recovery compared with passive rest (4.11 +/- 1.35 mmol.L-1). Submaximal swimming proved to be most effective at lowering blood lactate, but electrical muscle stimulation also reduced blood lactate 20 minutes postexercise significantly better than resting passive recovery. Electrical muscle stimulation shows promise as an alternate recovery treatment for the purpose of lowering blood lactate.

The current state of the profession of clinical exercise physiology in the United States is that of evolution. Individuals now identified as clinical exercise physiologists (CEPs) first emerged in health care in the nascent cardiac rehabilitation programs in the late 1960s and have remained strongly identified in that role ever since. However, the profession has had difficulty expanding into other similar areas, largely due to the lack of standardized academic preparation. This contributes to uncertainty and confusion among other health care providers regarding appropriate roles and responsibilities for a CEP. Future directions for the profession of clinical exercise physiology include requiring certification candidates to graduate from accredited programs so the academic preparation becomes standardized. The American College of Sports Medicine (ACSM) is currently investigating modifying the eligibility criteria for the ACSM-CEP certification to address this requirement. The Clinical Exercise Physiology Association is currently assembling a writing team to draft a CEP scope of practice document for the support and endorsement of other professional organizations The last item is the strengthening or creation of liaisons with other professions to develop a collaborative care model that takes full advantage of the skillset CEPs bring to chronic disease management.

Apply It! • Readers will be able to advocate for the field of clinical exercise physiology with an enhanced understanding of the current state of the profession. • Readers will have a platform to have discussions with other allied health professionals to increase awareness of the role of a clinical exercise physiologist in a health care setting.