Exercise and Fitness Programming for Special Populations

🧍‍♂Populations in Fitness Programming

Special Populations

• Pregnant women

• Older adults (geriatrics)

• Adults with chronic health conditions

General Population

• Children & adolescents (ages 5–17)

• Adults (ages 18–65)

🧒 Children & Adolescents (5–17 years)

Current Physical Activity Stats (Ireland)

• Only 13% meet PA guidelines (60 mins MVPA/day)

• Boys more active than girls at post-primary level

• Community sport participation remains high (80% primary, 58% post-primary)

• Physical Education: Still limited — 18% of primary students get ≤30 mins/week

• Obesity rates increasing:

  • 1990: 13%

  • 2006: 18%

  • 2020: 24% (8% obese)

  • Higher rates in lower-income groups

Sedentary Behavior Risks

• Linked to:

  • Weight gain

  • Poor heart/metabolic health

  • Behavioral issues

  • Sleep disruption

🧠 Benefits of Exercise in Youth

• Aerobic + Resistance + Bone-loading exercises boost:

  • Weight control

  • Bone density

  • Mental health

  • Injury prevention

  • Cognitive & academic performance

• Prepubescent children benefit similarly to adolescents

📋 Exercise Prescription & FITT Guidelines for 5–17 Years

Aerobic

• Frequency: Daily (vigorous 3x/week)

• Intensity: Moderate to vigorous

• Time: ≥60 mins/day

• Type: Games, sports, swimming, cycling, dancing

Resistance

• Frequency: ≥3x/week

• Intensity: Bodyweight or light/moderate load (8–15 reps with good form)

• Time: Part of the 60 mins/day

• Type: Structured (push-ups, bands) & unstructured (playground, climbing)

Bone Strengthening

• Frequency: ≥3x/week

• Intensity: Moderate to high impact

• Time: Part of daily 60 mins

• Type: Jumping, running, hopscotch, basketball, resistance

🧬 Resistance Training in Youth

• Safe when supervised and properly instructed

• Proven benefits across ages 6–18 regardless of development stage

• Fewer reps, higher intensity = better strength gains (Lesinski et al., 2016)

• Helps with strength, motor skills, and injury prevention

📖 National Guidelines (Ireland) – 5–17 Years

• Average 60 mins/day of moderate-to-vigorous aerobic activity

• Include vigorous, muscle-strengthening, and bone-strengthening exercises at least 3 days/week

• Limit sedentary time, especially recreational screen use

🏋‍♂️ Resistance Training (RT) for Children and Adolescents

🔧 Program Design

• Target major muscle groups; emphasize compound, multi-joint, functional movements

• Use a variety of modalities: free weights, machines, body weight, calisthenics

• Machines may not be sized for children and often have large resistance increments

📈 Progression

• Focus on increasing repetitions before increasing load

• Use light loads to master technique (Pepin et al., 2018)

🧰 Equipment & Technique

• Use child-sized equipment to ensure safe, effective movement

• Maintain the inverse relationship between intensity and volume

• Prioritize technique over external load

• Avoid overtraining and acute injury (Lloyd et al., 2013)

🏁 Initial Prescription

• Low volume (1–2 sets), low-moderate intensity (≤60% 1RM)

• Exercises can vary in sets/reps depending on the type and goal

• Sample for experienced youth:

  • 3×3 Power movement (e.g., Clean)

  • 3×3–5 Compound (e.g., Squat)

  • 2×6–8 Unilateral (e.g., Dumbbell Lunge)

⏱ Recovery & Frequency

• Children recover faster → 1 min rest often sufficient

• Higher intensity = 2–3 min rest

• 2–3 sessions/week on non-consecutive days optimal

❌ Common Misconceptions vs ✅ Evidence

👵 Exercise for Older Adults (65+ years)

⚠ Age-Related Physiological Declines

• Strength, power, bone density, muscle mass

• Cardiac output, balance, stability

✅ Benefits of Regular PA

• Slows aging-related changes

• Enhances ADL, strength, balance, QoL

• Reduces falls, boosts longevity (ACSM, 2022; Cadore et al., 2013)

💪 Resistance Training

• ≥2 days/week

• Intensity: 40–50% 1RM (beginners) → progress to 60–80% 1RM

• 8–10 exercises, 1–3 sets, 8–15 reps

• Include power training (30–60% 1RM at high velocity)

🏃 Aerobic Training

• Frequency: 3–5 days/week

• Intensity: 5–6 (moderate), 7–8 (vigorous) on 0–10 scale

• Time: 30–60 mins moderate or 20–30 mins vigorous

• Type: Low-impact (walking, cycling, swimming)

🧘 Flexibility

• ≥2 days/week

• Hold each stretch 30–60 sec to point of tightness

🧠 Functional & Cognitive Training

• Practice ADL-like movements: stepping, carrying, lifting, balancing

• Combine cognitive + physical (e.g., walk while counting)

📋 Notable Case Study – Richard Morgan (93 y/o)

• Started exercising at 73; now a world champion rower

• Weekly routine: ~30km rowing, 2–3 RT sessions

• VO₂max ≈ 28 ml/kg/min — equal to a healthy 30–40 y/o

• 225W peak power output; superior fitness for age

• Training split: 70% light, 20% mod–vigorous, 10% high intensity

🤰 Exercise During Pregnancy

🩺 ACSM Guidelines

• Encourage moderate-intensity PA during pregnancy to:

  • Improve fitness, reduce excessive weight gain

  • Lower gestational diabetes and postpartum depression risks

⚠ Special Risks

• Overheating

• Fall risk (especially in later trimesters)

• Avoid supine exercises in 2nd/3rd trimester

📈 Physiological Changes

• Cardiovascular: ↑ blood volume (30–50%), stroke volume, HR (up to 60% rise)

• Respiratory: ↑ tidal volume and ventilation, ↓ residual volume

• Musculoskeletal:

  • Center of gravity shifts → postural changes

  • Common: low back pain, carpal tunnel, pelvic pain

• Weight Gain Recommendations (IOM 2009):

  • Underweight: +12–18 kg | Normal: +12–16 kg

  • Overweight: +7–11 kg | Obese: +5–9 kg

🔄 Nutritional Needs

• +300 kcal/day after 13th week

• Increased carb utilization during rest & exercise

✅ Benefits of Exercise in Pregnancy

• Improve well-being, energy, sleep, weight control

• Reduce back pain, enhance muscle strength (Pivarnik et al., 2006; Larsson and Lindqvist, 2005)

🩺 Health Benefits of Physical Activity (PA) During Pregnancy

PA can help prevent or reduce:

• Excessive weight gain

• Gestational diabetes (especially in obese women)

• Preeclampsia

• Urinary incontinence

• Low back pain (LBP)

• Negative mood (improves mood!)

• Risk of Caesarean section

• Length of labor

• Decline in cardiorespiratory fitness (CRF)

🏃‍♀ Safe Exercise Types During Pregnancy

Choose exercises that:

• Are low risk (no falling or abdominal trauma)

• Are weight-supportive and don’t shift your balance too much

✅ Recommended Exercises:

• Aquatic exercise (like aqua jogging)

• Prenatal yoga (helps with balance & back pain)

• Kegels (strengthen pelvic muscles, prevent incontinence)

🗓 When to Start Exercise During Pregnancy

• Best to start a new exercise program in the 2nd trimester

  • Why? Many women feel sick in the 1st trimester
    (Sources: Pruett & Caputo, ACSM, 2021)

🏋‍♀️ Resistance Training (RT) During Pregnancy

🛑 Must:

• Get doctor’s approval before starting

✅ If approved:

• RT can be a safe and helpful part of a pregnancy workout
  (Source: Schoenfeld, 2011)

⚠ Notes:

• Limited research on RT safety, but generally okay if already training

• Talk to your doctor about how to adjust your routine
  (Source: ACSM, 2021)

🔧 Core Training During Pregnancy

Helps reduce back pain and support your spine.

✅ Best Core Exercises:

• Static (hold) exercises = safer and effective

  • Less strain on spine

⚠ Avoid:

• Crunches later in pregnancy — hard to do and less safe

📋 Examples of Safe Core Exercises (Schoenfeld, 2011)

• Plank

  • Hold body straight on forearms and toes

• Bird Dog

  • On hands & knees, extend opposite arm and leg — hold

• Side Bridge (Side Plank)

  • Lie on side, prop on one arm, hold body in line