NASM STUDY GUIDE CH 23: Chronic Health Conditions and Special Populations

60 minutes (1 hour)

Current recommendations state that children and adolescents should get _ or more of moderate to vigorous physical activity daily.

Exercise regimens that combine resistance training to increase BMD with flexibility, core, and balance training

what is important to enhance proprioception are important for clients with osteoporosis and osteopenia?

Rheumatoid arthritis (RA)

An autoimmune disease where the immune system mistakenly attacks the lining of the joints, causing inflammation, pain, swelling, and stiffness.

Osteoarthritis (OA)

A degenerative joint disease in which the protective cartilage at the ends of bones wears down over time.

acute rheumatoid arthritis exacerbation.

A sudden flare-up of rheumatoid arthritis symptoms.

exercise benefits with clients who have cancer

can improve exercise tolerance, reduce the cellular risks associated with cancer, and improve quality of life.

dyspnea.

Clients with lung disease experience fatigue at low levels of exercise and often experience

leg pain

the primary limiting factor for exercise in the client with PAD is

Progression for the youth population should be based on postural control and not on the amount of weight that can be used

Make exercising fun

exercise considerations for youth clients

Progression should be slow, well monitored, and based on postural control.

Exercises should be progressed, if possible, toward free sitting (no support) or standing.

Make sure the client is breathing in a normal manner and avoids holding their breath, as in a Valsalva maneuver.

If the client cannot tolerate self-myofascial techniques or static stretches, they can opt for slow and controlled active and dynamic stretches.

Exercise considerations for older adults

Make sure client is comfortable—be aware of positions and locations in the facility your client is in.

Exercises should be performed in a standing or seated position.

Clients may have other chronic diseases; in such cases, a medical release should be obtained from the individual’s physician.

Resistance exercises performed in a circuit-training manner, with higher repetitions, such as 20, may be used if tolerated by the individual.

Exercise considerations for overweight or obese clients

Make sure client has appropriate footwear and have client or physician check feet for blisters or abnormal wear patterns.

Advise client or class participant to keep a snack (quick source of carbohydrate) available during exercise to avoid sudden hypoglycemia.

Avoid excessive plyometric training, and higher-intensity training is not recommended for clients with diabetes.

Self-myofascial techniques may be contraindicated; a physician’s approval is recommended.

Exercise considerations for diabetic clients

Avoid heavy lifting and Valsalva maneuvers—make sure client breathes normally.

Do not let client over grip weights or clench fists when training.

Modify tempo to avoid extended isometric and concentric muscle actions.

Perform exercises in a standing or seated position. • Allow client to stand up slowly to avoid possible dizziness.

Progress client slowly.

Use circuit or peripheral heart action system (PHA) weight training as an option, with appropriate rest intervals. Tempo should not exceed 1 second for isometric and concentric portions of the lift.

Exercise considerations for hypertensive clients

Be aware that clients may have other diseases to consider as well, such as diabetes, hypertension, peripheral vascular disease, or obesity.

Modify tempo or pace to avoid extended isometric and concentric muscle actions.

Avoid heavy lifting and Valsalva maneuvers—make sure client breathes normally.

Do not let client overgrip weights or clench fists when training.

Perform exercises in a standing or seated position.

Progress exercise slowly.

Use circuit or peripheral heart action system (PHA) weight training as an option, with appropriate rest intervals. Tempo should not exceed 1 second for isometric and concentric portions of the lift.

Exercise considerations for clients with coronary heart disease

Progression should be slow, well monitored, and based on postural control.

Exercises should be progressed, if possible, toward free sitting (no support) or standing

Focus exercises on hips, thighs, back, and arms.

Avoid excessive spinal loading on squat and leg press exercises.

Make sure the client is breathing in normal manner and avoids holding their breath, as in a Valsalva maneuver.

Exercise considerations for clients with osteoporosis

Avoid heavy lifting and high repetitions. However, high repetitions with low load may be appropriate.

Stay in pain-free ranges of motion.

Start out with only 5 minutes of exercise, if needed, and progressively increase, depending on the severity of conditions.

May use a circuit or peripheral heart action training system.

Exercise considerations for arthritic clients

Avoid heavy lifting in initial stages of training.

Allow for adequate rest intervals and progress client slowly.

There may be a need to start with only 5 minutes of exercise and progressively increase, depending on the severity of conditions and fatigue.

May use a circuit or peripheral heart action training system.

Exercise considerations for clients with cancer

Avoid exercises in a prone (on stomach) or supine (on back) position after 12 weeks of pregnancy.

Avoid self-myofascial techniques on varicose veins and areas of swelling.

Plyometric training is not advised in the second and third trimesters.

Moderate- to high-intensity resistance exercise may be used in the first trimester if the client is accustomed to exercise; however, in the second and third trimesters, lower-intensity exercise programs are advised.

Exercise considerations for pregnant clients

Upper-body exercises cause increased dyspnea and must be monitored.

Allow for sufficient rest between exercises.

Peripheral heart action training system is recommended.

Exercise considerations for clients with lung disease

Allow for sufficient rest between exercises.

Workout may start with 5–10 minutes of activity.

Slowly progress client.

A circuit-training format is recommended.

Exercise considerations for clients with intermittent claudication or PAD