Chapter 16: Chronic Health Conditions and Physical or Functional Limitations Flashcards
obesity
the condition of subcutaneous fat exceeding the amount of lean body mass
diabetes
chronic metabolic disorder, caused by insulin deficiency, which impairs carbohydrate usage and enhances usage of fat and protein
hypertension
- high blood pressure
- consistently elevated arterial blood pressure, which, if sustained at a high enough level, is likely to induce cardiovascular or end-organ damage
Valsalva maneuver
a maneuver in which a person tries to exhale forcibly with a closed glottis (windpipe) so that no air exits through the mouth or nose as, for example, in lifting a heavy weight. the Valsalva maneuver impedes the return of venous blood to the heart
osteopenia
a decrease in the calcification or density of bone as well as reduced bone mass
osteoperosis
condition in which there is a decrease in bone mass and density as well as an increase in the space between bones, resulting in porosity and fragility
arthritis
chronic inflammation of the joints
osteoarthritis
arthritis in which cartilage becomes soft, frayed, or thins out, as a result of trauma or other conditions
Rheumatoid arthritis
arthritis primarily affecting connective tissues, in which there is a thickening of articular soft tissue, and extension of synovial tissue over articular cartilages that have become eroded
cancer
any of various types of malignant neoplasms, most of which invade surrounding tissues, may metastasize to several sites, and are likely to recur after attempted removal and to cause death of the patient unless adequately treated
restrictive lung disease
the condition of a fibrous lung tissue, which results in a decreased ability to expand the lungs
chronic obstructive lung disease
the condition of altered airflow through the lungs, generally caused by airway obstruction as a result of mucus production
intermittent claudication
the manifestation of the symptoms caused by peripheral arterial disease
peripheral arterial disease
a condition characterized by narrowing of the major arteries that are responsible for supplying blood to the lower extremities
what ages does “youth” include
6-20
although a group of children or adolescents may be the same age, their response to exercise can vary considerably as a result of individual differences in…………..
growth, development, and physical matruation
current recommendations state the children and adolescents should get _____ or more of physical activity daily
60 minutes (1 hour)
children and adolescents should engage in ____, _____, and ____ activities daily to improve their health and reduce their risk of developing chronic disease
aerobic, muscle-strengthening, and bone-strengthening activities
true or false: NASPE recommends that children ages 5=12 get up to 60 minutes of exercise daily
TRUE
-in response to the growing problem of obesity and diabetes in American children
peak oxygen uptake in children vs. adults
- adjusted for body weight, peak oxygen consumption is similar for young and mature males, and slightly higher for young females compared to mature females
- a similar relationship also exists for force production, or strength
submaximal oxygen demand (or economy of movement) in children vs. adults
-children are less efficient and tend to exercise at a higher percentage of their peak oxygen uptake during submaximal exercise compared with adults (submaximal oxygen demand is higher)
why is the term “peak oxygen uptake” more appropriate than “VO2max” for children?
because children to not typically exhibit a plateau in oxygen uptake at maximal exercise
levels of glycolytic enzymes in children vs. adults
-children do not produce sufficient levels of glycolytic enzymes to be able to sustain bouts of high-intensity exercise
thermoregulatory systems in children vs. adults
-children have immature thermoregulatory systems, including both a delated response and limited ability to sweat in response to hot, human environments
VO2 peak is similar to adults - implication of exercise compared with adult
able to perform endurance tasks relatively well
VO2 peak is similar to adults - considerations for health and fitness
physical activity of 60 minutes on most or all days of the week for elementary school children, emphasizing developmentally appropriate activities
VO2 peak is similar to adults - considerations in sport and athletic training
progression of aerobic training volume should not exceed 10% per period of adaptation (if weekly training volume was 200 minutes per week, increase to 220 minutes before further increases in intensity)
submaximal oxygen demand is higher in children - implication of exercise compared with adult
greater chance of fatigue and heat production in sustained higher-intensity tasks
submaximal oxygen demand is higher in children - considerations for health and fitness
moderate to vigorous physical activity for adolescents, for a total of 60 minutes 3 or more days of the week or 3 days per week if vigorous
submaximal oxygen demand is higher in children - considerations in sport and athletic training
intensive anaerobic exercise exceeding 10 seconds is not well tolerated (if using stage II or III training, provide sufficient rest and recovery intervals between intense bouts of training)
glycolytic enzymes are lower in children - implication of exercise compared with adult
decreased ability to perform longer duration (10-90 seconds), high-intensity tasks
glycolytic enzymes are lower in children - considerations for health and fitness
resistance exercise for muscular fitness:
- 1-2 sets of 8-10 exercise
- 8-12 reps per exercise
glycolytic enzymes are lower in children - considerations in sport and athletic training
- resistance exercise should emphasize proprioception, skill, and controlled movements
- repetitions should not exceed 6-8 set for strength development or 20 for enhanced muscular endurance
sweating rate in children - implication of exercise compared with adult
decreased tolerance to environmental extremes, particularly heat and humidity
lower absolute sweating rate in children - considerations for health and fitness
2-3 days per week, duration of 30 minutes, with added time for warm-up and cool-down
lower absolute sweating rate in children - considerations in sport and athletic training
2-3 days per week, with increases in overload occurring through increases in reps first, the resistance
vigorous exercise in hot, humid environments should be restricted for children to less than __ minutes, including frequent rest periods
30
true or false: resistance training is not safe for children and adolescents
FALSE
-research has clearly demonstrated that resistance training is both safe and effective in children and adolescents
resistance training for health and fitness conditioning in youth results in a lower risk of ___ when compared with many popular sports
injury
what are the most common injuries associated with resistance training in youth?
- sprains (injury to ligament)
- strains (injury to tendon or muscle_
what are injuries in youth during resistance training usually attributable to?
- lack of qualified supervision
- poor technique
- improper progression
true or false: children and adolescents can gain significant levels of strength as a result of resistance training beyond that normally associated with growth and development
TRUE
untrained children can improve their strength by an average of ___% after 8 weeks of progressive resistance training
30-40
resistance training in youth has been shown to improve…
- motor skills such as sprinting and jumping
- body composition
- bone mineral density
improvements in strength and performance after a resistance training program in youth appear to be owing to ___ versus muscular hypertrophy
neural adaptations
what is one of the most important aspects to consider when designing and implementing exercise training programs for youth?
make it safe and fun
as America’s population ages, we are faced with dealing with issues such as…
- mortality
- longevity
- quality of life
typical forms of degeneration associated with aging include…
- osteoporosis
- arthritis
- arthritis (osteoarthritis)
- low-back pain (LBP)
- obesity
mode of exercise for youth
walking, jogging, running, games, activities, sports, water activity, resistance training
frequency of exercise for youth
5-7 days of the week
intensity of exercise for youth
moderate to vigorous cardiorespiratory exercise training
duration of exercise for youth
60 minutes per day
movement assessment for youth
- overhead squats
- 10 push-ups (if 10 cannot be performed, do as many as can be tolerated)
- single-leg stance (if can tolerate, perform 3-5 single-leg squats per leg)
flexibility for youth
follow the flexibility continuum specific for each phase of training
resistance training for youth
- 1-2 sets of 8-12 repetitions at 40-70% on 2-3 days per week
- phase 1 of OPT model should be mastered before moving on
- phases 2-5 should be reserved for mature adolescents on the basis of dynamic postural control and a licensed physician’s recommendation
special considerations for youth
- progression for the youth population should be based on postural control and not on the amount of weight that can be used
- making exercise fun!
normal physiologic and functional changes associated with aging include reductions in the following:
- maximal attainable heart rate
- cardiac output
- muscle mass
- balance
- coordination (neuromuscular efficiency)
- connective tissue elasticity
- bone mineral density
blood pressure tends to be higher at rest and during exercise with age, which is the result of…
either natural causes, disease, or a combination of both
is arteriosclerosis a normal physiologic process of aging, or a result of disease?
normal
what does arteriosclerosis result in?
arteries that are less elastic and pliable, which in turn leads to greater resistance to blood blow and thus higher blood pressure
what is atherosclerosis a result of?
poor lifestyle choices (smoking, obesity, sedentary lifestyle, etc.)
what does atherosclerosis result in?
restricted blood flow as the result of plaque buildup within the walls of arteries, thus leading to increased resistance and blood pressure
peripheral vascular disease refers to plaques that form in any peripheral artery, typically those of the…
lower leg
prehypertensive blood pressure levels
between 120/80 and 139/89
hypertensive pressure levels
above 140/90
degenerative processes associated with aging can lead to a decrease in the functional capacity of older adults, including potentially significant reductions in….
muscular strength and endurance, cardiorespiratory fitness, and proprioceptive neural responses
what is one of the most important and fundamental functional activities affected with degenerative aging?
walking
the decreased ability to move freely in one’s own environment not only reduces the physical and emotional independence of an individual, it also can lead to any increase in __________
the degenerative cycle
the ability or inability to perform normal activities of daily living (ADLs) such as bathing, eating, housekeeping, and leisure activities can be measured to help determine the __________ of an individual
functional status
before initiating any exercise training, older adults must complete a _______ and _____
Physical Activity Readiness Questionnaire (PAR-Q) and movement assessment such as the overhead squat, sitting and standing from a seated position, or a single-leg stance
why is flexibility assessment and training an important consideration with older adults?
because they tend to lose the elasticity of their connective tissue, which reduces movement and increases the risk of injury
what kind of flexibility training is advised for seniors?
- SMR and static stretching, provided there is a sufficient ability to perform the necessary movements
- otherwise, simple forms of active or dynamic stretching can be recommended to help get the client to start moving their joints during the warm-up period
what cardiorespiratory stages are appropriate for seniors?
stages I and II
mode of exercise for seniors
stationary or recumbent cycling, aquatic exercise, or treadmill with handrail support
frequency of exercise for seniors
3-5 days per week of moderate-intensity activities or 3 days per week of vigorous-intensity activities
intensity of exercise for seniors
40-85% of VO2 max
duration of exercise for seniors
30-60 minutes per day or 8-10 minute bouts
movement assessments for seniors
push, pull, OH squat, or sitting and standing into a chair, single-leg balance
flexibility for seniors
SMR and static stretching
resistance training for seniors
- 1-3 sets of 8-20 repetitions at 40-80% on 3-5 days per week
- phase 1 of OPT model should be mastered before moving on
- phases 2-5 should be based on dynamic postural control and a licensed physician’s recommendation
special considerations for seniors
- 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 normal manner and avoid holding breath as in a Valsalva maneuver
maximal oxygen uptake, maximal exercise heart rate, and measures of pulmonary function will all decrease with increasing age - implications of health and fitness training
- initial exercise workloads should be low and progressed more gradually to 3-5 days per week
- duration = 20-45 minutes
- intensity = 45-80% of peak
percentage of body fat will increase, and both bone mass and lean body mass will decrease with increasing age - implications of health and fitness training
resistance exercise is recommended, with lower initial weights and slower progression (for example, 1-3 sets of 8-10 exercises, 8-20 reps, session length = 20-30 minutes)
balance, gait, and neuromuscular coordination may be impaired - implications of health and fitness training
- exercise modalities should be chosen and progressed to safeguard against falls and foot problems
- cardio options include stationary or recumbent cycling, aquatic exercise, or treadmill with handrail support
- resistance options include seated machines, progressing to standing exercises
there is a higher rate of both diagnosed and undetected heart disease in the elderly - implications of health and fitness training
knowledge of pulse assessment during exercise is critical, as is monitoring for chronic disease signs and symptoms
pulse irregularity is more frequent - implications of health and fitness training
careful analysis of medication use and possible exercise effects
what is the fastest growing health problem in America?
obesity
__% of Americans older than age 20 are overweight
66
approximately __% of Americans are obese
34
what is obesity associated with?
a variety of chronic health condition’s, as well as emotional and social problems
body mass index is used to estimate ____
healthy body weight ranges based on a person’s height
what is BMI defined as?
total body weight in kilograms divided by the height in meters squared
true or false: BMI is helpful in developing weight loss goals
FALSE
-because BMI does not actually measure body composition, other techniques such as skin-fold or circumference measurements may be performed to assist in developing realistic weight loss goals and to help provide feedback to clients
true or false: assessing body fat using skinfold calipers is the best option for obese individuals
FALSE
-it can be a sensitive situation
although BMI is not a perfect measurement, it does provide reliable values for…..
comparison and goal setting
normal BMI
18.5-24.9
overweight BMI
25-29.9
obese BMI
> 30
what fraction of adults in the US have a BMI of 25 or greater?
2/3
what fraction of adults in the US have a BMI of 30 or greater?
1/3
true or false: the risk of chronic diseases increases in proportion to the rise in BMI in both adults and adolescents
TRUE
what is the primary problem regarding obesity?
obesity (too many calories consumed and too few expended)
it has been suggested that adults who remain sedentary throughout their life span will lose approximately __ pounds of muscle per decade, while simultaneously adding __ pounds of fat per decade
5, 15
the average adult will experience a __% reduction in fat-free mass (FFM) between the ages of 30 and 80
15
true or false: body fat is an age-related problem
FALSE
-it relates to the number of hours individuals spend exercising per week
it has been shown in sedentary individuals that daily-activity levels account for more than __% of the variability of body-fat storage in men
75
what is one of the most important factors related to long-term successful weight loss?
regular physical activity and exercise
true or false: obese and morbidly obese clients have unique problems associated with exercise
TRUE
true or false: heavier individuals exhibited worse balance, slower gait velocity, and shorter steps, regardless of their level of muscular strength
TRUE
exercise training for obese clients should focus primarily on what?
energy expenditure, balance, and proprioceptive training to help them expend calories and improve their balance and gait mechanics
by performing exercises in a proprioceptively enriched environment (controlled, unstable), the body is forced to…
recruit more muscles to stabilize itself, potentially expending more calories
for effective weight loss, obese calories should expend ___ calories per exercise session, with a minimum weekly goal of ___ calories of energy expenditure from combined physical activity and exercise
200-300, 1250
the initial energy expenditure goal of 1250 calories per week should be progressively increased to ___ calories per week
2000
true or false: resistance training can gradually be added to any exercise program designed to promote weight loss, but sustained long-term aerobic endurance activities will always remain a priority
TRUE
true or false: circuit-style resistance training, when compared with walking at a fast pace, produces nearly identical caloric expenditure rates in the same given time span
TRUE
why is resistance training an important component of any weight-loss program?
because it helps increase lean body mass, which eventually results in a higher metabolic rate and improved body composition
true or false: the same exercise training guidelines for apparently healthy adults can be used when designed aerobic and resistance training programs for obese clients
TRUE
fitness assessments for obese clients
pushing, pulling, and squatting assessments
for obese clients, resistance training exercises for assessment or training may be best performed with ____ from a ____ position
cables, exercise tubing, or body weight from a standing or seated position
true or false: a single-leg squat is more appropriate than a single-leg balance assessment for obese clients
FALSE
-using a single-leg balance assessment may be more appropriate than a single-leg squat for obese clients
what position should flexibility exercises be performed from for obese clients?
standing or seated position
true or false: SMR is highly recommended for obese clients
FALSE
-SMR should be used with caution and may need to be avoided or performed at home
why is core and balance training important for obese clients?
because they lack balance and walking speed, both of which are important to exercise
why must personal trainers use caution when placing an obese client in a prone or supine position?
because these obese individuals are prone to both hypotensive and hypertensive responses to exercise
which phases are appropriate for the obese population?
phases 1 and 2
what should personal trainers lookout for in obese clients performing resistance training exercises?
- ensure that the client is breathing correctly
- ensure that the client avoids straining during exercise or squeezing bars too tightly, which can cause an increase in blood pressure
obesity is a unique chronic disease because it also affects a person’s sense of _____ and _____
emotional well-being and self-esteem
true or false: obesity can alter the emotional and social aspects of a person’s life as much as it does the physical aspects
TRUE
what will help create trust between the client and professional and assist the client in adhering to a weight-loss and exercise program?
personal trainers must be very aware of the psychological aspects of obesity when training obese clients to ensure that the client feels socially and emotionally safe
true or false: machines are a good option for obese individuals
FALSE
-machines are often not designed for obese individuals and may require a significant amount of mobility to get in and out
what kind of exercise modalities are best for obese clients?
dumbbells, cables, or exercise tubing exercises
why should SMR be used with caution in obese clients?
- obese clients may not feel comfortable rolling or lying on the floor
- may be better done in privacy
it is recommended that obese clients engage in _____ to decrease orthopedic stress
weight-supported exercise (such as cycling or swimming)
___ is often both a preferred activity for many obese clients and one that is easily engaged and adhered to
walking
things to consider when working with obese clients
- exercise positions
- locations in the training facility that offer greater privacy
- choice of exercise equipment
obese clients may have other comorbidities (diagnosed or undiagnosed) including hypertension, cardiovascular disease, or diabetes - considerations for health and fitness
initial screening should clarify the presence of potential undiagnosed comorbidities
maximal oxygen uptake and ventilatory (anaerobic threshold) is typically reduced in obese clients - considerations for health and fitness
- consider testing and training modalities that are weight-supported (such as cycle ergometer, swimming)
- if a client does not have these limitations, consider a walking program to improve compliance
coexisting diets may hamper exercise ability and result in significant loss of lean body mass for obese clients - considerations for health and fitness
- initial programming should emphasize low intensity, with a progression in exercise duration (up to 60 minutes as tolerable) and frequency (5-7 days per week), before increases are made in intensity of exercise
- exercise intensity should be no greater than 60-80% of work capacity, with weekly caloric volume a minimum of 1250 kcal per week and a progression to 2000, as tolerable
measures of body composition (hydrostatic weighing, skin0fold calipers) may not accurately reflect degree of overweight or obesity - considerations for health and fitness
BMI, scale weight, or circumference measurements are recommended as measures of weight loss
mode of exercise for obese clients
low-impact or step aerobics (such as treadmill walking, rowing, stationary cycling, and water activity)
frequency or exercise for overweight clients
at least 5 days per week
intensity of exercise for obese clients
- 60-80% of maximum heart rate
- use the talk test to determine exertion
- stage I cardiorespiratory training progressing to stage II (intensities may be altered to 40-70% of maximal heart rate if needed)
duration of exercise for obese clients
40-60 minutes per day, or 20-30 minute sessions twice each day
assessment for obese clients
- push, pull, squat
- single-leg balance (if tolerated)
flexibility for obese clients
- SMR (only if comfortable to client)
- flexibility continuum
resistance training for obese clients
- 1-3 sets of 10-15 repetitions on 2-3 days per week
- phases 1 and 2 will be appropriate performed in a circuit-training manner (higher repetitions such as 20 may be used)
special considerations for obese clients
- make sure your 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
- may have other chronic diseases; in such cases a medical release should be obtained from the individual’s physician
type 1 diabetes
- insulin-dependent diabetes
- the body does not produce enough insulin
- younger individuals
- hyperglycemia or hypoglycemia
type 2 diabetes
- non-insulin dependent diabetes
- the body cannot respond normally do the insulin that is made
- associated with obesity
- hyperglycemia
diabetes is associated with a greater risk for…
heart disease, hypertension, and adult-onset blindness
what is type 2 diabetes strongly associated with?
an increase in childhood and adult-onset obesity (particularly abdominal obesity)
true or false: some individuals with type 2 diabetes cannot manage their blood glucose levels and do require additional insulin
TRUE
who is type 1 diabetes typically diagnosed in?
children, teenagers, or young adults
with type 1 diabetes, specialized cells in the pancreas called ____ stop producing insulin, causing blood levels to ___
beta cells, rise
hyperglycemia
high levels of blood sugar
how do individuals with type 1 diabetes control for high levels of blood sugar?
they must inject insulin to compensate for what the pancreas cannot produce
exercise ____ the rate at which cells utilize glucose
increases
if an individual with type 1 diabetes foes not control his or her blood glucose levels before, during, and after exercise, blood sugar levels can drop rapidly and cause a condition called ____
hypoglycemia
hypoglycemia
low blood sugar
what does hypoglycemia lead to?
weakness, dizziness, and fainting
what are the primary components prescribed for individuals with type 1 diabetes?
insulin, proper diet, and exercise
individuals with type 2 diabetes usually produce adequate amounts of insulin; however, their cells are resistant to the insulin, leading to _________
hyperglycemia (high blood sugar)
chronic hyperglycemia is associated with a number of disease associated with damage to the ______
kidneys, heart, nerves, eyes, and circulatory system
true or false: individuals with type 2 diabetes experience the same fluctuations in blood sugar as those with type 1 diabetes
FALSE
what are the most important goals of exercise for individuals with either type of diabetes?
glucose control
what is the most important goal of exercise for individuals with type 2 diabetes?
weight loss
how can exercise training help with glucose control and weight loss?
it has a similar action to insulin by enhancing the uptake of circulating glucose by exercising skeletal muscle
exercise improves a variety of glucose measures, including…
tissue sensitivity, improved glucose tolerance, and even a decrease in insulin requirements
why must caution be taking when prescribing walking to clients with diabetes?
it is important to prevent blisters and foot microtrauma that could result in foot infection
why should special care be taken with respect to giving advice to clients with diabetes regarding carbohydrate intake and insulin use?
to reduce the risk of a hypoglycemic or hyperglycemic event
why should special care be given to SMR in clients with diabetes?
SMR may be contraindicated for anyone with peripheral neuropathy (loss of protective sensation in feet and legs)
what phases are appropriate for clients with diabetes?
phases 1 and 2
true or false: plyometric training may be inappropriate for clients with diabetes
TRUE
mode of exercise for clients with diabetes
low-impact activities (such as cycling, treadmill walking, low-impact or step aerobics)
frequency of exercise for clients with diabetes
4-7 days per week
intensity of exercise for clients with diabetes
- 50-90% of maximum heart rate
- stage I cardiorespiratory training (may be adjusted to 40-70% of maximal heart rate if needed) progressing to stages II and II based on a physician’s approval
duration of exercise for clients with diabetes
20-60 minutes
assessment for clients with diabetes
- push, pull, OH squat
- single-leg balance or single-leg squat
flexibility for clients with diabetes
flexibility continuum
resistance training for clients with diabetes
- 1-3 sets of 10-15 repetitions 2-3 days a week
- phases 1 and 2 of the OPT model (higher repetitions such as 20 may be used)
special considerations for clients with diabetes
- 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
- use SMR with special care and licensed physician’s advice
- avoid excessive plyometric training, and higher-intensity training is not recommended for typical client
blood pressure
the pressure exerted by the blood against the walls of the blood vessels, especially the arteries
what does blood pressure vary with?
- strength of the heartbeat
- the elasticity of the arterial walls
- the volume and viscosity of the blood
- a person’s health, age, and physical condition
hypertensive measurement
> 140 / >90
prehypertensive measurement
between 120/80 and 135/85
normal blood pressure
less than 120.80
common causes of hypertension
- smoking
- a diet high in fat (particularly saturated fat)
- excess weight
health risks of hypertension
increased risk for stroke, cardiovascular disease, chronic heart failure, and kidney failure
methods of controlling hypertension
- antihypertensive medications
- regular physical activity
- diet
- smoking cessation
research has shown that exercise can have a modest impact on lowering elevated blood pressure by an average of ___ mm Hg for both systolic and diastolic blood pressure
10
true or false: low to moderately intense cardiorespiratory exercise has been shown to be just as effective as high-intensity activity in reducing blood pressure
TRUE
individuals with hypertension frequently take medications that alter what?
the heart rate response to exercise, in most cases blunting the heart rate response to exercise, thus invalidating prediction equations or estimates of training heart rate
supine or prone positions can often ____ blood pressure
increase
what kinds of stretching are easiest and safest for clients with hypertension?
static and active
why may SMR may be contraindicated for clients with hypertension?
it requires lying down
for clients with hypertension, cardiorespiratory endurance training should focus on what stage?
stage I, and progress only after a physician’s approval
true or false: plyometric training is recommended for clients with hypertension
FALSE
-use plyometric training with care for this population
what position should resistance training be performed in for clients with hypertension?
a seated or standing position
what phases are appropriate for clients with hypertension?
phases 1 and 2
programs for clients with hypertension should b e performed in a ___ or ___ training system to distribute blood flow between the upper and lower extremities
circuit-style of Peripheral Heart Action (PHA)
personal trainers should always ensure that clients with hypertension….
- try and breath normally
- avoid the Valsalva maneuver
- avoid over gripping (squeezing too tightly) when using exercise equipment
personal trainers should monitor clients with hypertension carefully when ________, as they may experience dizziness
rising from a seated or lying position
mode of exercise for clients with hypertension
- stationary cycling
- treadmill walking
- rowers
frequency of exercise for clients with hypertension
3-7 days per week
intensity of exercise for clients with hypertension
- 50-85% of maximal heart rate
- stage I cardiorespiratory training progressing to stage II (intensities may be altered to 40-70% of maximal heart rate if needed)
duration of exercise for clients with hypertension
30-60 minutes
assessment for clients with hypertension
- push, pull, OH squat
- single-leg balance (squat if tolerated)
flexibility for clients with hypertension
static and active in a standing or seated position
resistance training for clients with hypertension
- 1-3 sets of 10-20 repetitions 2-3 days per week
- phases 1 and 2 of the OPT model
- tempo should not exceed 1 second for isometric and concentric portions (e.g. 4/1/1 instead of 4/2/1)
- use circuit or PHA weight training as an option, with appropriate rest intervals
special considerations for clients with hypertension
- avoid heavy lifting and Valsalva maneuvers: make sure client breathes normally
- do not let client overgrip weights or clench fists when training
- modify tempo to avoid extended isometric and concentric muscle action
- perform exercises in a standing or seated position
- allow client to stand up slowly to avoid possible dizziness
- progress client slowly
blood pressure response to exercise may be variable and exaggerated, depending on the mode and level of intensity, in clients with hypertension - considerations for health and fitness, sport, and athletic training
- a program of continuous, lower-intensity (50-85% of work capacity) aerobic exercise is initially recommended
- frequency an duration parameters should be at a minimum 3-5 days per week, 20-45 minutes per day, with additional increases in overall volume of exercise if weight loss is also desired
despite medication, hypertensive clients may arrive with preexercise hypertension - considerations for health and fitness, sport, and athletic training
- resistance exercise should consist of a Peripheral Heart Action or circuit-training style
- avoid Valsalva maneuvers (holding breath), emphasize rhythmic breathing and a program design for muscular fitness (e.g., 1-3 sets of 8-10 exercises, 10-20 reps, 2-3 days per week)
hypertension is frequently associated with other comorbidities, including obesity, cardiovascular disease, and diabetes - considerations for health and fitness, sport, and athletic training
- screening for comorbidities is important
- exercise should target a weekly caloric goal of 1500-2000 kcal, progressing as tolerable, to maximize weight loss and cardio protection
some medications, such as beta-blockers, for hypertension will attenuate the heart rate at rest and its response to exercise - considerations for health and fitness, sport, and athletic training
- for clients taking medications that will influence heart rate, do not use predicted maximal heart rate or estimates for the exercise
- instead, use actual heart rate response or the Talk test
- accepted blood pressure contraindications for exercise include an SBP of 200 mm Hg and DBP of 115 mm Hg
what is the leading cause of death and disability?
coronary heart disease (CHD)
CHD is caused by ______, which leads to narrowing of the coronary arteries and ultimately angina pectoris, myocardial infarction, or both
atherosclerosis (plaque formation)
angina pectoris
chest pain
myocardial infarction
heart attack
causes of CHD
- cigarettes smoking
- poor diet
- physical inactivity
the emphasis of treating CHD is centered on…
improving the internal lining of the coronary artery, called plaque “stabilization”
CHD treatment
- medical management: pharmaceuticals
- aggressive lifestyle intervention: eating better, getting more exercise, smoking cessation, stress reduction
true or false: clients must be able to find and monitor their own pulse rate or use an accurate monitor to stay below their safe upper limit of exercise
TRUE
true or false: the heart rate response to exercise will vary considerably from age-predicted formulas in clients with CHD , and will often be higher
FALSE
-it will often be lower
benefits of exercise for clients with CHD
- lower risk of mortality (death)
- increased exercise tolerance
- muscle strength
- reduction in angina and heart failure symptoms
- improved psychological status and social adjustment
true or false: there is evidence that heart disease may be slowed (or even reversed) when a multifactor intervention program of intensive education, exercise, counseling, and lipid-lowering medications are used, as appropriate
TRUE
true or false: plyometric training is not recommended for clients with CHD in the initial months of training
TRUE
mode of exercise for clients with CHD
large muscle group activities, such as stationary cycling, treadmill walking, or rowing
frequency of exercise for client with CHD
3-5 days/week
intensity of exercise for clients with CHD
- 40-85% of maximal heart rate reserve
- the talk test may also be more appropriate as medications may affect heart rate
- stage I cardiorespiratory training
duration of exercise for clients with CHD
5-10 minutes of warm-up, followed by 20-40 minutes of exercise, followed by 5-10 minutes of cool-down
assessment for clients with CHD
- push, pull, OH squat
- single-leg balance (squat if tolerated)
flexibility for clients with CHD
static and active in a standing or seated position
resistance training for clients with CHD
- 1-3 sets of 10-20 repetitions 2-3 days per week
- phases 1 and 2 of the OPT model
- tempo should not exceed 1 second for isometric and concentric portions (e.g., 4/1/1 instead of 4/2/1)
- use circuit or PHA weight training as an option, with appropriate rest intervals
specific considerations for clients with CHD
- be aware that clients may have other diseases to consider as well, such as diabetes, hypertension, peripheral vascular disease, or obesity
- modify tempo to avoid extended isometric and concentric muscle action
- 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
in clients with CHD, resistance training should not be started until the client has been exercising without problems for __ months
3
the nature of CHD may result in a specific level of exercise, above which it is dangerous to perform - considerations for health and fitness, sport and athletic training
- the upper safe limit of exercise, preferably by heart rate, must be obtained
- heart rate should never be estimated from existing prediction formulas for clients with heart disease: consult their physician
clients with CHD may not have angina (chest pain equivalent) or other warning signs - considerations for health and fitness, sport and athletic training
clients must be able to monitor pulse rate or use an accurate monitor to stay below the upper safe limit of exercise
between the underlying disease and medication use, the heart rate response to exercise in clients with CHD will nearly always vary considerably from age-predicted formulas, and will almost always be lower - considerations for health and fitness, sport and athletic training
although symptoms should always supersede anything else as a sign to decrease or stop exercising, some clients may not have this warning system, so monitoring of heart rate becomes increasingly important
CHD clients may have other comorbidities (such as diabetes, hypertension, peripheral vascular disease, or obesity) - considerations for health and fitness, sport and athletic training
screening for comorbidities is important and modifications to exercise may be made based on these diagnoses
peak oxygen uptake (as well as ventilatory threshold) is often reduced in clients with CHD because of the compromised cardiac pump and peripheral muscle deconditioning - considerations for health and fitness, sport and athletic training
-the exercise prescription should be low intensity, to start, and based
on recommendations provided by a certified exercise physiologist or
physical therapist with specialty training
-aerobic training guidelines should follow, at minimum, 20–30 minutes 3–5 days per week at 40–85% of maximal capacity, but below the upper safe limits prescribed by the physician
-a weekly caloric goal of 1,500–2,000 kcal is usually recommended, progressing as tolerable, to maximize cardio protection
-resistance training may be started after the patient has been exercising asymptomatically and comfortably for >3 months in the aerobic exercise program
-a circuit-training format is recommended, 8–10 exercises, 1–3 sets of
10–20 reps per exercise, emphasizing breathing control and rest as needed between sets
what is a precursor to osteoperosis?
osteopenia
type 1 (primary) osteoporosis
associated with normal aging and is attributable to a lower production of estrogen and progesterone, both of which are involved with regulating the rate at which bone is lost
type 2 (secondary) osteoporosis
caused by certain medical conditions that can disrupt normal bone reformation, including alcohol abuse, smoking, certain diseases, or certain medications
true: the actual proteins in bone are altered in osteoporosis
TRUE
why is type 2 osteoporosis most prevalent in postmenopausal women?
-because they have a deficiency in estrogen
bone resorption
removal of old bone
bone remodeling
formation of new bone
what leads to a decrease in bone mineral density?
bone resorption & remodeling
what does osteoporosis commonly affect?
the neck of the femur and the lumbar vertebrae, placing the core in a weakened state
peak bone mass
the highest amount of bone mass a person is able to achieve during his or her lifetime
new bone formation occurs as result of…
stress placed on the musculoskeletal system
risk factors that influence osteoporosis
- peak bone mass
- lack of physical activity
- smoking
- excess alcohol consumption
- low dietary calcium intake
what is required to maintain consistent bone remodeling?
remaining active enough to ensure adequate stress is being placed on the body
mode of exercise for individuals with osteoporosis
treadmill with handrail support
frequency of exercise for individuals with osteoporosis
2-5 days per week
intensity of exercise for individuals with osteoporosis
- 50-90% if maximal heart rate
- stage I cardiorespiratory training progressing to stage II
duration of exercise for individuals with osteoporosis
20-60 minutes per day or 8-10 minute bouts
assessment for individuals with osteoporosis
push, pull, overhead squat, or sitting and standing into a chair (if tolerated)
flexibility for individuals with osteoperosis
static and active stretching
resistance training for individuals with osteopersosis
- 1-3 sets of 8-20 repetitions at up to 85% on 2-3 days per week
- phases 1 and 2 of the OPT model should be mastered before moving on
special considerations for individuals with osteoporosis
- 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 a normal manner and avoid holding breath as in a Valsalva maneuver
maximal oxygen uptake and ventilatory threshold is frequently lower in clients with osteoporosis, as a result of chronic conditioning - considerations for health and fitness, sport and athletic training
typical exercise loads prescribed are consistent with fitness standards: 40-70% of maximum work capacity, 3-5 days per week, approximately 20-30 minutes per session
gait and balance may be negatively affected in clients with osteoporosis - considerations for health and fitness, sport and athletic training
physiologic and physical limitations point to low-intensity, weight-supported exercise programs that emphasize balance training
chronic vertebral fractures may result in significant lower-back pain in clients with osteoporosis - considerations for health and fitness, sport and athletic training
- for clients with osteopenia (and no contraindications to exercise), resistance training is recommended to build bone mass
- loads >75% of 1RM have been shown to improve bone density, but clients must be properly progressed to be able to handle these loads
- a circuit-training format is recommended, 8-10 exercises, 1 set of 8-12 reps per exercise, with rest as needed between sets
age, disease, physical stature, and deconditioning may place the osteoporosis client at risk for falls - considerations for health and fitness, sport and athletic training
- for clients with severe osteoporosis, exercise modality should be shifted to water exercise to reduce risk of loading fracture (if aquatic exercise is not feasible, use other weight-supported exercise, such as cycling, and monitor signs and symptoms)
- reinforce other lifestyle behaviors that will optimize bone health, including smoking cessation, reduced alcohol intake, and increased dietary calcium intake
true or false: individuals who participate in resistance training have a higher bone mineral density than those who do not
TRUE
resistance training has been shown to improve bone density by no more than __%
5
it has been estimated that a __% increase in bone mineral density is necessary to offset fractures
20
higher intensities (__%) are needed to stimulate bone formation
75-85
it appears that ___ (rather than the number of repetitions) is the determining factor in bone formation
load
it generally takes about __ months of consistent exercise at relatively high intensities before any effect on bone mass is realized
6
2 most common types of arthritis
- osteoarthritis
2. rheumatoid arthritis
osteoarthritis is caused by the degeneration of ___
cartilage within joints
some of the most commonly affected joints in osteoarthritis are in the…
hands, knees, hips, and spine
the lack of cartilage as a result of osteoarthritis results in what?
wearing on the surfaces of articulating bones, causing inflammation and pain at the joint
rheumatoid arthritis is a degenerative joint disease in which the body’s immune system mistakenly….
attacks its own tissue (in this case, tissue in the joint or organs)
some of the most commonly affected joints in rheumatoid arthritis are in the…
hands, feet, wrists, and knees
what is rheumatoid arthritis typically characterized by?
morning stiffness, lasting more than half an hour, which can be both acute and chronic, with eventual loss of joint integrity
pain persisting for more than __ after exercise is an indication that the exercise should be modified or eliminated from the routine
1 hour
exercises of higher intensity or involving higher repetitions are to be avoided to decrease ___
joint aggravation
clients taking oral corticosteroids, particularly over time, may have….
osteoporosis, increased body mass, and, if there is a history of gastrointestinal bleeding, anemia
steroids increase ___ risk
fracture
research indicates that people exhibiting osteoarthrosis have a decrease in ____ and ____
strength and proprioception
what is a strong predictor of osteoarthrisis?
loss in knee-extensor strength
patients with osteoarthrosis exhibit increased ____ of knee extensors, and were not able to effectively activate their knee-extensor musculature to optimal levels
muscle inhibition
symptoms of arthritis are heightened through inactivity as a result of ___ and ____
muscle atrophy and lack of tissue flexibility
mode of exercise for individuals with arthritis
treadmill walking, stationary cycling, and low-impact of step aerobics
frequency of exercise for individuals with arthritis
3-5 days per week
intensity of exercise for individuals with arthritis
- 60-80% of maximal heart rate
- stage I cardiorespiratory training progressing to stage II (may be reduced to 40-70% of maximal heart rate if needed)
duration of exercise for individuals with arthritis
30 minutes
assessment for individuals with arthritis
- push, pull, overhead squat
- single-leg balance of single-leg squat (if tolerated)
flexibility for individuals with arthritis
SMR and static and active stretching
resistance training for individuals with arthritis
- 1-3 sets of 10-12 repetitions 2-3 days per week
- phase 1 of OPT model with reduced repetitions (10-12)
- may use a circuit or PHA training system
special considerations for individuals with arthritis
- avoid heavy lifting and high repetitions
- stay in pain-free ranges of motion
- only use SMR if tolerated by the client
- there may be a need to start out with only 5 minutes of exercise and progressively increase, depending on the severity of conditions
maximal oxygen uptake and ventilatory threshold are frequently lower in arthritis clients as a result of decreased exercise associated with pain and joint inflammation - considerations for health and fitness, sport and athletic training
- multiple sessions or a circuit format, using treadmill, elliptical trainer, or arm and leg cycles, are a better alternative than higher-intensity, single-modality exercise formats
- the usual principles of aerobic exercise training apply (60-80% peak work capacity, 3-5 days per week)
- duration of exercise should be an accumulated 30 minutes, following an intermittent or circuit format, 3-5 days per week
medications may significantly influence bone and muscle health in arthritis clients - considerations for health and fitness, sport and athletic training
incorporate functional activities in the exercise program whenever possible
tolerance to exercise may be influenced by acute arthritic flare-ups - considerations for health and fitness, sport and athletic training
awareness of the signs and symptoms that may be associated with acute arthritis flare-ups should dictate a cessation or alteration of training, and joint pain persisting for more than 1 hour should result in an altered exercise format
rheumatoid arthritis results, in particular, in early morning stifness - considerations for health and fitness, sport and athletic training
avoid early morning exercise for clients with rheumatoid arthritis
evaluate for presence of comorbidities in arthritis clients, particularly osteoporosis - considerations for health and fitness, sport and athletic training
- resistive exercise training is recommended, as tolerable, using pain as a guide
- start with a very low number of repetitions and gradually increase to the number usually associated with improved muscular fitness (e.g., 10-12 reps, before increasing weight, 1 set of 8-10 exercises, 2-3 days per week)
positive benefits of exercise in the treatment of cancer
- improved aerobic and muscular fitness
- retention of lean body mass
- less fatigue
- improved quality of life
- positive effects on mood and self-concept
- reduce cellular risks associated wit cancer
- improve exercise tolerance
medications used by clients with cancer can result in substantial adverse effects, such as…
peripheral nerve damage, cardiac and pulmonary problems, skeletal muscle myopathy (muscle weakness and wasting), and anemia, as well as frequent nausea
mode of exercise for individuals with cancer
treadmill walking, stationary cycling, rowers, low-impact or step aerobics
frequency of exercise for individuals with cancer
3-5 days per week
intensity of exercise for individuals with cancer
- 50-70% of maximal heart rate reserve
- stage I cardiorespiratory training progressing to stage II (may be reduced to 40-70% of maximal heart rate if needed)
duration of exercise for individuals with cancer
15-30 minutes per session (may only start with 5 minutes)
assessment for individuals with cancer
- push, pull, overhead squat
- single-leg balance (if tolerated)
flexibility for individuals with cancer
SMR and static and active stretching
resistance training for individuals with cancer
- 1-3 sets of 10-15 repetitions 2-3 days per week
- phases 1 and 2 of the OPT model
- may use a circuit or PHA training system
special considerations for individuals with cancer
- avoid heavy lifting in initial stages of training
- allow for adequate rest intervals and progress client slowly
- only use SMR if tolerated by the client- avoid SMR for clients undergoing chemotherapy or radiation treatments
- there may be a need to start with only 5 minutes of exercise and progressively increase, depending on the severity of conditions and fatigue
exercise at ____ intensities for moderate durations appears to have a more positive effect on the immune system (when compared with higher intensities for longer durations)
low to moderate
the majority of observed disparities in athletic performance between men and women are explained by differences in…
- body structure
- muscle mass
- lean to fat body mass ratio
- blood chemistry
those already engaged in an exercise program before pregnancy may continue with moderate levels of exercise until __________, when a logical reduction in activity is recommended
the third trimester
the gradual growth of the fetus can alter the ___ of pregnant women
posture
things to avoid in later stages of pregnancy
- prone or supine positions
- hip abduction or adduction
- uncontrolled twisting motions of the torso
women in the childbearing period are more vulnerable to….
nausea, dizziness, and fainting
pregnant women should immediately stop exercising if they experience nausea, dizziness, or fainting, along with any…
abdominal pain (or contractions), excessive shortness of breath, or bleeding or leakage of amniotic fluid
changes that occurred during pregnancy may persist for ______ after pregnancy
a month to a month and a half
postnatal women should be encouraged to reeducate.
- posture
- joint alignment
- muscle imbalances
- stability
- motor skills
- recruitment of the deep core stabilizers such as the transverse abdominis, internal oblique, and pelvic floor musculature
in pregnant women, SMR should not be performed on…
varicose veins that are sore, or on areas where there is swelling (such as the calves)
appropriate precautions can minimize the risks of exercise during pregnancy, including…..
increased blood circulation, thermoregulatory changes, or decreased oxygen supply
mode of exercise for pregnant women
low-impact or step aerobics that avoid jarring motions, treadmill walking, stationary cycling, and water activity
frequency of exercise for pregnant women
3-5 days per week
intensity of exercise for pregnant women
stage I and only enter stage II on a physician’s advice
duration of exercise for pregnant women
- 15-30 minutes per day
- there may be a need to start out with only 5 minutes of exercise and progressively increase to 30 minutes, depending on the severity of conditions
assessment for pregnant women
- push, pull, overhead squat
- single-leg squat or balance
flexibility for pregnant women
static, active stretching and SMR
resistance training for pregnant women
- 2-3 days per week, using light loads at 12-15 repetitions
- phases 1 and 2 of the OPT model are advised (use only phase 1 after first trimester)
special considerations for pregnant women
- avoid exercises in prone or supine position after 12 weeks of pregnancy
- avoid SMR on varicose veins and areas of swelling
- plyometric training is not advised in the second and third trimesters
contraindications include persistent bleeding into 2nd or 3rd trimester, medical documentation of incompetent cervix or intrauterine growth retardation, pregnancy-induced hypertension, preterm rupture of membrane, or preterm labor during current or prior pregnancy - considerations
screen carefully for potential contraindications to exercise
decreased oxygen available for aerobic exercise in pregnant women - considerations
low-moderate intensity aerobic exercise (40-50% of peak work capacity) should be performed 3-5 days per week, emphasizing non-weight bearing exercise (e.g., swimming, cycling), although certain treadmill or elliptical training modes may be preferred and are appropriate
posture can affect blood flow to uterus during vigorous exercise in pregnant women - considerations
avoid supine exercise, particularly after first trimester
even in the absence of exercise, pregnancy may increase metabolic demand by 300 kcal per day to maintain energy balance - considerations
advise adequate caloric intake to offset exercise effect
high-risk pregnancy considerations include individuals older than age of 35, history of miscarriage, diabetes, thyroid disorder, anemia, obesity, and a sedentary lifestyle
-there are no published guidelines for resistance,
flexibility, or balance training specific to pregnancy
exercise
-provided exercise intensity is below the aerobic prescription of 40–50% of peak work capacity, with careful attention to special
considerations and contraindications described, adding these components may be helpful
-for resistance training, if cleared by the physician,
a circuit-training format is recommended, 1–3 sets
of 12–15 reps per exercise, emphasizing breathing
control and rest, as needed, between sets
-advise clothing that will dissipate heat easily during exercise
-postpartum exercise should be similar to pregnancy guidelines, as physiologic changes that occur during pregnancy may persist for up to 6 weeks
major obstructive lung diseases
- asthma
- chronic bronchitis
- emphysema
what are obstructive lung diseases characterized by?
chronic inflammation and airway obstruction via mucus production
cystic fibrosis
a genetic disorder that is characterized by excess mucus production
impairments during exercise due to chronic lung disease
- decreased ventilation
- decreased gas exchangeability (resulting in decreased aerobic capacity and endurance and in oxygen desaturation)
dyspnea
shortness of breath
clients with lung disease experience…
fatigue at low levels of exercise and often have shortness of breath
those with emphysema are frequently ______ and may exhibit ______
underweight, overall muscle wasting with hypertrophied neck muscles (which are excessively used to assist labored breathing)
those with chronic bronchitis are _______
oversight and barrel-chested
the use of ____ cardiorespiratory and resistance training exercises seem to be best tolerated in those with lung disease
lower body
upper extremity exercises place an increased stress on…
the secondary respiratory muscles that are involved in stabilization the upper extremities during exercise
true or false: the Peripheral Heart Action training system is highly recommended for those with lung disease
FALSE
-may need to avoid upper body exercises
in some clients, inspiratory muscle training can specifically improve ____
the work associated with breathing
mode of exercise for individuals with lung disease
treadmill walking, stationary cycling, steppers, and elliptical trainers
frequency of exercise for individuals with lung disease
3-5 days per week
intensity of exercise for individuals with lung disease
- 40-60% of peak work capacity
- stage I
duration of exercise for individuals with lung disease
work up to 20-45 minutes
assessment for individuals with lung disease
- push, pull, overhead squat
- single-leg squat or balance
resistance training for individuals with lung disease
- 1 set of 8-15 repetitions 2-3 days per week
- phase 1 of the OPT model is advised
- PHA training system is recommended
flexibility for individuals with lung disease
static and active stretching and SMR
special considerations for individuals with lung disease
- upper body exercises cause increased dyspnea and must be monitored
- allow for sufficient rest between exercises
lung disease frequently is associated with other comorbidities, including cardiovascular disease - considerations
screen for presence of other comorbidities
a decrease in the ability to exchange gas in the lungs may result in oxygen desaturation and marked dyspnea at low workloads - considerations
- if possible and properly trained, ascertain the level of oxygen saturation using a pulse oximeter
- pulse oximetry values should be above 90% and certainly above 85%: values above this level are a contraindication to continued exercise, regardless of symptoms
chronic deconditioning results in low aerobic fitness and decreased muscular performance in clients with lung disease - considerations
- the aerobic exercise prescription should be guided by the client’s shortness of breath
- workloads of 40-60% of peak work capacity 3-5 days per week, 20-45 minutes as tolerable, may be achievable
- intermittent exercise with frequent rest breaks may be necessary to achieve sufficient overall exercise duration
upper extremity exercise may result in earlier onset of dyspnea and fatigue than expected, when compared with lower extremity exercise - considerations
- upper extremity exercise should be programmed carefully and modified, based on fatigue
- resistance training can be helpful; use conservative guidelines
- circuit training in a PHA format is recommended (8-10 exercises, 1 set of 8-15 reps per exercise), emphasizing breathing control and rest as needed between sets
lung disease clients may have significant muscle wasting and be of low body weight (with a BMI <18)
if the client is very thin, be certain to recommend adequate caloric intake to offset exercise effects
lung disease clients may be using supplemental oxygen
- trainers may not adjust oxygen flow during exercise; it is considered a medication
- if a client experiences unusual dyspnea or has evidence of oxygen desaturation during exercise, stop exercise immediately and consult with the client’s physician
what is intermittent claudication characterized by?
limping, lameness, or pain in the lower leg during mild exercise resulting from a decrease in blood supply (oxygen) to lower extremities
what is the primary limiting factor for exercise in a client with peripheral arterial disease?
leg pain
exercise for peripheral arterial disease should induce symptoms, causing a stimulus that increases _____
local circulation
the health and fitness professional must differential between true intermittent claudication versus what?
similar leg complaints associated with deconditioning
mode of exercise for individuals with PAD
treadmill walking is preferred, also stationary cycling, steppers, and elliptical trainers
frequency of exercise for individuals with PAD
3-5 days per week working up to everyday
intensity of exercise for individuals with PAD
50-85% of maximal heart rate
duration of exercise for individuals with PAD
work up to 20-30 minutes
assessment for individuals with PAD
- push, pull, overhead squat
- single-leg squat or balance
flexibility for individuals with PAD
static and active stretching
resistance training for individuals with PAD
- 1-3 sets of 8-12 repetitions 2-3 days per week, and slowly increasing up to 12-20 reps
- phase 1 of the OPT model is advised
special considerations for those with PAD
- allow for sufficient rest time between exercises
- workout may start with 5-10 minutes of activity
- slowly progress client
