There are certainly other trainers who can help her with her back, and her overall health. You know, ones she hasn't slept with.
Consequences.
My wife had to QUIT her job at the gym, something she had studied HARD for her certification to get, and she had worked to build up her clientele. But it was something she needed to do in order to maintain no-contact and come back to the marriage. She was ANGRY about it . . . at first at me, but later admitted "I was angry at myself, that I didn't have more self-control and let myself get into a situation where I had to give that up, in order to work on our marriage."
Again, there are two separate issues here: BOUNDARIES and NO-CONTACT/TRANSPARENCY. Engine will not be in a position to insist upon the latter until such time as his wife asks the "What will it take?" question, so he can't forbid her from using this trainer. But he can damned sure stop PAYING for it -- and should.