Chapter 23 - Chronic Health Conditions and Special Populations

Given the alarming increase in childhood obesity and diabetes, what do current youth fitness guidelines focus on?

Promote healthy lifestyle and health related physical fitness - children and adolescents should get 60+ minutes moderate to vigorous exercise daily

What has research clearly demonstrated about resistance training in children and adolescents?

Safe and effective

What is it important to understand about children vs adults?

Fundamental physiological differences

How can older adults, with or without chronic conditions, respond to exercise?

Much in same manner as young healthy adults

What is one of the most important factors related to long term successful weight loss?

Regular physical activity and exercise

What affect has exercise been shown to have on the treatment of and prevention of type 2 diabetes?

Substantial positive effect

Clients with stable coronary artery disease, especially those who have participated in a cardiac rehab program, should be taught what benefits of exercise for them?

Lower risk of mortality, increased exercise tolerance, muscle strength, reduction in angina and heart failure symptoms, and improved psychological status

Exercise regimens that combine resistance training to increase Bone Mineral Density (BMD) and flexibility, core, and balance training to enhance proprioception are important for clients with what diagnoses?

Osteopenia (warning of BMD loss) and osteoporosis (severe BMD loss)

What is the difference between rheumatoid and osteo arthritis?

Rheumatoid Arthritis (RA) = systemic, inflammatory autoimmune disease (immune system attacks healthy cells)

Osteoarthritis (OA) = localized, degenerative joint disease (wear and tear)

What are the signs and symptoms of an acute rheumatoid arthritis exacerbation?

Joint pain

Swelling and effusion (fluid build up)

Warmth and redness

Morning stiffness

Systemic fatigue

Why should fitness professionals monitor the progress of clients with arthritis?

Assess effects of exercise program on joint pain

Why is exercise an important intervention for clients recovering from cancer?

Can improve exercise tolerance, reduce cellular risks associated with cancer, and improve quality of life

What has substantial research shown exercise does during pregnancy for the mother and fetus?

Beneficial effects on physiology and health

What do clients with lung disease experience at low levels of exercise?

Fatigue and often dyspnea

What is PAD?

Peripheral Artery Disease

What is the primary limiting factor for exercise in a client with PAD?

Leg pain

What should you consider with youth clients?

Progression based on postural control and NOT amount of weight that can be used

Make exercising fun

What should you consider with older adult clients?

Slow, well monitored progression based on postural control

Make sure client breathing in a normal manner

What should you consider with diabetic clients?

Self myofascial techniques contraindicated - physician approval recommended

Avoid excessive plyometrics or high intensity training

Advise client to keep carb filled snack in case of hypoglycemia

Appropriate footwear and check for blisters or abnormal wear patterns

What should you consider with hypertensive clients?

Avoid heavy lifting and Valsalva maneuver - make sure client breathes normal

Do not let client over grip weights or clench fists

Avoid extended isometric or concentric actions

Standing or seated exercises

Client stands up slowly

Slow progression

What should you consider with clients who have coronary heart disease?

May have other chronic diseases

Avoid extended isometric and concentric actions

Avoid heavy lifting and Valsalva maneuver - make sure breathing normally

Standing or seated exercises and progress slowly

What should you consider with clients who have osteoporosis?

Slow, well monitored progression based on postural control

Should progress exercises (if possible) to free sitting or standing

Focus exercises on hips, thighs, back, and arms

Avoid excessive spinal loading

Normal breathing and no Valsalva maneuver

What should you consider with clients who have arthritis?

Avoid heavy lifting and high reps (with low loads may be appropriate though)

Pain free ROM only

Start 5 minutes of exercise and progress safely

What should you consider with clients who have cancer?

Avoid heavy lifting in initial stages

Adequate rest intervals and slow progression

May need to start with 5 minutes then progress safely

What should you consider with pregnant clients?

Avoid prone (stomach) and supine (back) positions after 12 weeks of pregnancy

Avoid self myofascial techniques on varicose veins and swollen areas

Plyometrics NOT advised in second and third trimesters

High intensity in first trimester okay if client accustomed, but later low intensity recommended

What should you consider with clients who have lung disease?

Upper body exercises cause increased dyspnea - must be monitored

Sufficient rest

Peripheral Heart Action (PHA) training system recommended

What should you consider with clients who have intermittent claudication or PAD?

Sufficient rest

Start 5-10 minutes then progress safely

Slow progression

Circuit training format recommended