The Role of Occupational Therapists in Solving the Wellness Paradox with Emilee Moore

This paradox , as I view it , is the trust , interaction and communication gap that exists between fitness professionals and our medical community . This podcast is all about closing off that gap by disseminating the latest , most evidence-based and most engaging information in the health sciences . And to do that , in episode 123 , we're joined by Emily Moore .

Emily is finishing up her academic experience as an occupational therapist and in fact , this is the first time we've actually had an OT on the podcast .

And the reason I was so intrigued to have this conversation is Emily has conducted her research as well as where she's taking her career , with the role OTs can play in care coordination and referral to qualified exercise professionals in the community .

As I say , in the podcast episode , oftentimes we think about relationships with physical therapists or primary care physicians or dietitians , but we very rarely think about a relationship with a occupational therapist . So I think Emily brings a very unique and different perspective towards bridging the wellness paradox gap that we talk about so often .

Any information we'd like to share with you from today's episode can be found on the show notes page , that's by going to wellnessparadoxpodcom forward slash episode one , two , three . Please enjoy this conversation with Emily Moore Today . We're delighted to be joined by Emily Moore . Emily , thank you so much for joining us .

So , david , thank you so much for introducing Emily to me for what I think is going to be a really interesting conversation . I think our paths are very similar and aligned in terms of what we're trying to do .

But before we dive into this discussion , why don't you just tell us a little bit more about yourself and your background to provide some context for the conversation ?

My doctoral capstone project is in regards to making physical activity accessible and inclusive for those with disabilities .

It kind of started out as a more encompassing topic of just people marginalized from the gym older adults , individuals with disabilities and low socioeconomic status but kind of has morphed into really hyper , focusing on those with intellectual disabilities because I've kind of found through my research that those are often the most marginalized .

But kind of how I got to the topic of my research is through working as a respite care provider while going through occupational therapy school . I did it to pay the bills and with my knowledge as a physical trainer that there was so much benefit that could come from looking at exercise through the OT lens .

So that's kind of what birthed my idea for my research and why I'm here today .

You and I met at the ACSM Idea Health Fitness Summit this year in Chicago a couple months back , and when talking to you it's clear that you definitely have a strong background as a fitness and an exercise professional , but you've also gone through this academic and clinical program for OT and you're trying to blend both worlds to a certain degree .

And what's interesting is that we've had physical therapists on the podcast before . We've had exercise physiologists on the podcast before .

You were the first occupational therapist that we've had on the podcast and are a soon-to-be occupational therapist , I should say , and because of that I was really excited to have the conversation , because I think it brings an interesting perspective .

So , before I get into really talking about your research , I think there's one point that we need to clarify for our audience , because they actually may not know the difference . Can you explain , maybe , the difference between an occupational therapist and a physical therapist ?

Because I think most people just contextually understand physical therapy , but they may not understand OT so well . So let's touch on that and then we'll get into your research .

Occupation is anything that brings meaning to an individual's life and for me , exercise , physical activity , has brought so much meaning on a physical , mental , social platform , so that's the occupation that I'm really choosing to advocate and educate people on .

There's actually a term within the occupational therapy framework called health management routines , in which I am operating my research underneath . But an OT can work in schools , they can work in hospitals , they can work in community-based programs .

They're just helping any individual reach their personalized goals by approaching it from a very holistic standpoint the mind , body and the environment , and how it's interacting to support or inhibit the individual .

So , diving in a little bit , let's talk about your research in particular , specifically the role occupational therapists can play in care coordination and helping assist patients get referred to qualified exercise professionals . In some sense , your role as an OT in bridging the wellness paradox that I talk about so often .

So not only do I believe that this is the role that we can play , there's a lot of really big associations , like the World Health Association , that are noticing such the vital role that occupational therapists play in preventative healthcare .

So kind of our current model of practice is physicians are diagnosing individuals with diabetes or chronic health conditions and saying , okay , go out , exercise , eat healthy , but aren't giving people the tools to do it .

People go out , they look up online all these fad diets and exercise routines and come back three months later with the same problems or maybe even worse than they were off before .

On the other side of that , we have these fitness professionals who are qualified to work with special populations , who are informed on nutrition and how to build an exercise program , but they're not communicating with the patients or the doctors .

So I really think that the role that OT can play is to come in and fill that gap , be that communication center to aid in that continuum of care .

A physician can refer you to an occupational therapist and an occupational therapist can have this toolbox of all the resources within the community to be like Jill you enjoy water aerobics , you have a lot of arthritis and you need a low impact exercise . Here's Bill .

He's a special aquatics exercise professional and I'm going to send you over to him so he can help motivate you and provide you with services that you're interested in and make it a routine , rather than just offhandingly trying to go to a large gym , do something by yourself and maybe even getting injured .

So that's kind of the dream that I have created for myself .

And there's actually an article that was posted in 2020 from the American Occupational Therapy Association that calls out occupational therapists for this role in health promotion and basically states that we need to become more integrated in the communities and advocate for more community-based wellness opportunities , like getting into the typical gym setting .

So I think it's a really cool opportunity that occupational therapists have to promote that preventative healthcare model rather than working on the opposite side on that sick care .

And then what are some things you think we might need to do , or your profession might need to do , to move towards that ideal state ?

So people are coming in , getting diagnosed with illnesses , maybe getting sent to the hospital , and then after that we're seeing them and we're teaching them how to have proper body mechanics to do things like put on your clothes , move your laundry .

So we're doing it after the injury or after the illness has already occurred , which it plays a very vital role in the recovery process . But what if we flipped the table and we taught people proper body mechanics and got them connected with the right fitness professionals , healthcare professionals , the right wellness team , before those illnesses ever occurred ?

Imagine how much better off our society would be without having to worry about all these different chronic conditions and back injuries and joint injuries , if we could teach them before the injuries happened . Um , kind of how it can shift .

There's currently a big push within the occupational therapy profession moving into primary health care physician offices and kind of the dream that I have is that gyms will also bring on occupational therapists to help aid in that entry process .

So doing some primary health screenings , motivational interviewing and figuring out really how to connect with those people right when they enter into the door , because I think another really big factor that not a lot of people take into consideration is the motivation that it takes to start a new routine .

Ot is really embedded in those routine-based therapies or those routine-based everyday activities . So how do we motivate you to make this an everyday activity that you enjoy doing , rather than making it a chore that eventually you're going to fall off the wagon three months down the road when it's not motivating anymore ?

And I guess the specific question is , and because I wasn't even aware of this , what is the training and the education look like for OTs around ? You mentioned motivational interviewing and behavior change . I think we think of OTs or PTs sometimes we think it's , you know , they're kind of just doing stuff with the body , not necessarily with the mind as much .

So maybe touch on the coaching element , if you will .

In quite a few states throughout the United States , occupational therapists are qualified mental health professionals , and so it really is an all-encompassing profession in which we get to approach the person not only through their physical health but their social . Do you have the social supports you need to make these life changes ?

What types of activities or people are you surrounding yourself with that are setting you up for success and or failure ? Do you have access to the community where you can get these resources that you need to be successful ? So it really is this holistic , whole person , client-centered care .

Client-centered care is kind of a term that is embedded throughout the framework of occupational therapy , but it truly , I think , is what differentiates us from anyone else .

always learn , whenever I do any episodes , you know what , something new and I think just kind of understanding the depth and the breadth of the OT curriculum I think is very , very illuminating for myself as well as , I'm sure , the audience . So so let's sort of , you know , kind of move the discussion forward .

So we've established that , wow , ots could play a really big role in connecting patients that are kind of going through the healthcare system with qualified exercise professionals in the community . We've even talked about , wow , maybe this could be an opportunity to employ OTs in health and fitness clubs .

From your perspective , as someone who is viewing things through the occupational therapy lens , if you were going to refer to qualified exercise professionals in the community , what would be some of the key things that you would be looking for when making that referral in an exercise professional ?

If we can build this toolbox and I can know someone who specializes in aquatics , who specializes in dance , who specializes in yoga , who is really good at weight training , or I can find all these different connections within the community , I can make sure that I'm connecting people with people who are experts in their field .

So I'm a firm believer in advocating for what you're good at . So if there's a service that you know you can provide if you've gone through Exercise Connections , autism Exercise Specialist course and that's a service that you're good at and you can provide , I want to know about it so I can send any individual that aligns with your mission to you .

So I think advocating for and knowing what your mission is and what you're good at is the best way to market yourself . Yeah .

From an occupational therapy perspective , how do you think about exercise prescription for somebody ? Because I think sometimes in the fitness space and you've been a part of this space you know we think of it as all right , you do cardio and you lift , but and then that's it . Right , it's those two things .

But clearly you know , as an OT , you're thinking about things a little bit more broadly . Maybe you could touch on that for a second .

Me personally I love it , I love the mental challenge of it , but when we think about physical activity it truly is just getting your body moving . So in grad school , when I was in the didactic portion of the program , I actually gave a presentation about how your daily living tasks burn calories .

Something as simple as parking at the back of the parking lot , the grocery store and walking and pushing your grocery cart burns calories . Mowing your lawn burns calories . Putting your groceries away burns calories . Getting dressed burns calories .

So it's kind of redefining what physical activity means and figuring out what people's areas like interest areas are and educating them that like , hey , you can burn just as many calories in a Zumba class as you can walking on the treadmill for an hour If you enjoy dancing .

Let's put you in something that you're going to stick with and that can become something you look forward to rather than something you dread . So I think it's getting to know the people that you're working with and understanding that physical activity is not just confined to lifting weights and walking on a treadmill . It really can be any activity .

It's just getting creative to meet the needs of the client .

You need to find like-minded individuals that are willing to go on that crusade with you , and that's exactly what I found at the MRF Institute . The team over at the MRF Institute creates educational content for fitness and wellness professionals who are serious about becoming a part of our healthcare continuum .

Getting on the healthcare continuum is all about leveling up our skills to be looked at as that valued resource provider . The wellness paradox is certainly an avenue for you to do that , but we need many different levers to pull if we're going to get there , and the MRF Institute is definitely one of those levers .

Instituteorg to find all kinds of great , informative , free , informational content and if you choose to engage with any of their paid content , they've created a coupon code specifically for wellness paradox listeners . You can enter in WP 2022 , that's WP and then the number 2022 to the website at checkout to receive a 15% discount on your purchase .

I highly recommend you go check out mrfinstituteorg . Now back to today's episode . Yeah , well said , there's a relevance element there that I think is so important . If somebody finds something relevant and engaging I think we all know this from our life in general we're gonna be much more likely to do it .

As an example , I am a terrible dancer and very self-conscious when I'm dancing , so you're not gonna find that I would think a Zumba class would be relevant or engaging .

For me , it would probably be anxiety provoking , but I mean , I like to ride every bike and I like to lift weights , so those are things that I'll choose to engage with , and I think you said something earlier which I think is so true of most exercise professionals is that you love to exercise , but you're we're the people that listen to this podcast .

We're all in the minority , and so finding ways to make exercise fun and engaging is probably more important than what you're actually prescribing in and of itself , because if it's not fun or engaging , people aren't going to do it .

So figuring out the meaning , the routine and how to implement it into their life to bring meaning to them not necessarily what I think is going to be the best thing for them to their life to bring meaning to them , not necessarily what I think is going to be the best thing for them .

I'd be remiss not to ask you about it , because you've had this great experience at Exercise Connection with David and you're kind of expanding your perspective on how to make exercise more inclusive . We kind of started this conversation with that being an area that you are passionate about , which is what led you to David and exercise connection .

So I would be curious to get your perspective on what you could tell exercise professionals about making exercise more inclusive , not just for people with disabilities certainly we could focus on that but even more broadly .

But communication yeah , I've worked with individuals with autism throughout my education , throughout my different side jobs , as an ABA therapist , as a respite care provider and now here at Exercise Connection .

But communication doesn't just mean verbal , it means with your body language , it means using visuals , and I think that communication and pictures not or or say trying to think of how to say this best , but uh , pictures are worth a thousand words for those with intellectual disabilities , for those with the language barrier , and so if we can embed these visuals

throughout the the gym setting and make it a more welcoming place , changing the different advertisements A lot of times , advertisements post pictures with six pack and these shredded people , but that's not appealing to the general population .

So we have to think about how are we setting up the environment and how are we communicating in clients to make it look like it's an attainable thing ? We have to really take a different perspective than the exercise professional and understand what it looks like walking into the gym for someone who is novice . We are very comfortable inside the gym .

We know exactly what we do when we walk in there , but can they find the entrance to the gym ? Is it clearly marked ? Once they get into the entrance of the gym , do they know exactly who they're supposed to go and talk to and where they're supposed to go throughout the gym ? Are the advertisements in there welcoming and inclusive ?

Do they see people that look like them ? Do they see people with disabilities , or is it only ripped people who are genetically blessed to look the way that they do ? I think that appealing to the general public and people of all spreads of life is very important when we talk about starting a new routine very important when we talk about starting a new routine .

You see even fewer images and videos of people with physical and intellectual disabilities . So I do think being conscious of that is so important . One of the things that I love about the work that you guys do at Exercise Connection is David and you .

You guys create your own stuff , like you're not going and getting stock images from you know iPhoto online , like you're actually taking pictures of the real people that are doing the things that you're doing . And two things one , I think that's so powerful because other people can see somebody who's like them modeling the behavior .

And two , the reality is that you can't find the stock imagery or the stock B-roll online . You have to create it yourself . So I think that is a very important strategy that Exercise Connection employs , and I think that that's a strategy that the rest of the industry can take a lesson from .

We employ several different individuals that come in and help us build the kits , but also any materials that we release , any presentation we give , we send to our autism specialists .

They're a review board of individuals with autism that review our material and make sure that we are appropriately speaking and using terminology that reflects highly on the community that we are preaching towards , and so I think that having that perspective makes us really unique and I think it's a really powerful thing to have individuals with autism themselves advocating

and supporting our materials .

Look at your website , because there's what exercise professionals think should go up there , and then there's what connects with actual people .

So I love the fact that you guys embed that into your organization and I think that is another really good lesson for the industry broadly to take , because I think , if we did , I think we'd have decidedly different looking and sounding marketing materials out there than what we have right now .

If we had gym owners bring in individuals in wheelchairs or individuals with disabilities when designing their structures or laying out their gym equipment , I think it would also be a really different and interesting perspective that would bring so much value . That's something that I look at as an occupational therapist .

Is an individual with a wheelchair able to navigate through the gym spaces ? Is the equipment too close together ? If I have an individual with low stamina , do we have rest stations throughout the gym where they can be seated if they need to take a break ?

The gym where they can be seated if they need to take a break , and so those are different things that I think having an OT , but also individuals with the disabilities themselves as a part of that process , it would be inherently valuable .

But let's kind of transition then , as we bring this to a close , to talk about how exercise professionals , how fitness professionals , can work to collaborate with occupational therapists .

And I'll couch this question in the thought that I think that a lot of exercise professionals think , oh , I should establish a relationship with a physical therapist , a dietician , maybe a primary care physician . I don't necessarily think OT is on the top of that list , but after having this conversation it's clear that there's a great opportunity to collaborate .

So , from your perspective , as somebody who takes the OT lens and filters things through it , how would you like to see exercise and fitness professionals collaborate with OT and maybe what are some of the best practices you can give an exercise professional who's listening about how they could engage the occupational therapist community ?

If you have a client that's exercising that you notice needs some OT , needs some motivational interviewing , needs some body mechanics , maybe some modalities , it can be a relationship that goes in both directions .

So , knowing what you're good at and being able to communicate that and get out into the community and say this is what I do , this is what I'm good at , this is the service I'm able to offer , and so then I have that in my back pocket when I have clients come through my door and I can say , oh , I can send you over to Mike , he can help you out with

that , he specializes in this service . So I think connections are everything within the wellness business . You have to get your name out there and I think also you have to get the certifications to back . That's something that's very valuable and very important to me .

When I'm vetting who I'm going to send my clients to , I want to make sure that they're qualified to give the services that they're advertising .

So , looking into if you want to provide services for individuals with disability going to NCHPAD , coming to Exercise Connection , getting those certifications and having the evidence-based practices side of things , if you want to be an aquatics instructor , making sure that you have those proper , up-to-date certifications before you're advertising your services as so .

So certifications and connections , I think , are the two biggest things that I would advocate for .

So before we get to the last couple of questions , I do , I'm going to throw you one curveball question here , because I know you're finishing up your , your academic experience and you're about to go and start your professional , outside of academic career .

You've got this knowledge of exercise and this passion for movement and exercise , and now you have this academic experience in occupational therapy .

How are you going to blend these two when you get into the workforce and I know that's a scary question to ask anyone that's just about to graduate but how are you viewing what your career is going to look like to start out with these two very much related , but I mean , for all intents and purposes , separated domains of OT and then kind of traditional

gym-based exercise ? So do you have any thoughts on how you're going to bridge this gap for yourself , at least in the short term ?

But really the medical fitness association and that kind of model of practice is really my dream to be able to open a gym in which I can offer not only my physical modalities and occupational therapy services but also have a gym that is encompassed under that same roof where I can run group exercise classes , individual-based exercise classes , nutrition and have all of

the entities of what really makes up a wellness team under one roof . I think is how the future of healthcare is moving and something I very much would like to be a part of . Exercise is something I'm very passionate and very excited about , and I think combining that with my education will yield a lot of awesome opportunities .

But it is a very novel concept within the occupational therapy realm . It's something that I'm really advocating and trying to educate a bunch of people about is this is an option of what you can do for your career as an occupational therapist , and I'm hoping that someday it's not novel .

It's something they teach at all the occupational therapy schools that , hey , you can go work at a gym and you can help fitness professionals and physicians collaborate and communicate to help set people up for success and really aid in that preventative healthcare model . That's what I think I mentioned earlier .

The World Health Organization has named the occupational therapist the champion of preventative healthcare in the 2030 champion of preventative health care in the 2030 movement initiative . So I think that there's going to be a push from occupational therapists as a whole towards that role in the preventative health care model and I think that this is just the beginning .

I'm getting it at the precipice .

So an exciting time and , yes , I think , with your mindset , you're getting into the field at the right point . So where can people go if they want to find out more about you and the work that you're doing and will be doing ?

So if anyone has any questions or comments and they want to get ahold of me , I'll link my email and my LinkedIn account and we can definitely continue that conversation and connection connection .

I think , if nothing else , the more conversations we are having between exercise professionals and OT , the greater the likelihood OT is to become a champion of what we do , and we need as many champions inside the healthcare delivery system as we possibly can to get people moving more . So we'll definitely link up to all that .

My last question I'm going to ask that I'm really excited to ask you because again , you're bringing this occupational therapy perspective is that I'm really excited to ask you because again you're bringing this occupational therapy perspective ?

Is that you know I consider the wellness paradox to be this trust , interaction and communication gap between exercise professionals and the medical community . From your standpoint , if you can give the exercise professionals that are listening one piece of advice to close off that gap , what would it be ?

If you're going to be really good at providing exercise services , refer out to a nutrition specialist , refer out to an OT for those massage and just make sure that you are building a toolbox and honing in on your craft , staying in your lane but then gaining those valuable connections so that we can all work and practice to the best of our abilities and really

support our clients and doing what we do best . So I think not being afraid to send your clients elsewhere and forming those connections with other practitioners out into the community is going to be a really integral part of growing a business and being the best practitioner that you really can be .

Forward slash episode one , two , three . Please be on the lookout for our next episode when it drops in two weeks , and don't forget to subscribe through your favorite podcast platform Until we chat again next . Please be well .