Chapter 23 - Chronic Health Conditions and Special Populations Flashcards
1
Q
Define “Youth” in age-range terms.
A
- Youth: children and adolescents between ages 6-20
2
Q
What are the current exercise recommendations for children and adolescents?
A
- 60 minutes or more of physical activity daily
- Should engage in aerobic, muscle-strengthening, and bone strengthening activities daily to improve health and reduce risk of developing chronic disease
3
Q
True or False:
Children do not produce sufficient levels of glycolytic enzymes to be able to sustain bouts of high-intensity exercise.
A
True
4
Q
How do children differ from adults when it comes to exercise?
A
Children tend to have lower peak oxygen uptake levels, lower sweating rates, and lower tolerance for temperature extremes (compared to adults)
5
Q
Children and adolescents have lower glycolytic enzymes than adults resulting in a decreased ability to perform longer-duration (10-90sec) high-intensity tasks.
What types of health considerations should a personal trainer take into consideration in order to accommodate for this?
A
- Lower reps and sets with an emphasis on proprioception, skills, and controlled movement.
Resistance exercise for muscular fitness:
- 1-2 sets of 8-10 exercises
- 8-12 reps per exercise
- Resistance exercise should emphasize proprioception, skill, and controlled movements
- Repetitions should not exceed 6-8 per set for strength development or 20 for enhanced muscular endurance
6
Q
When working with children and adolescents, their submaximal oxygen demand is high compared with adults for walking and running.
What types of health considerations should a personal trainer take into consideration in order to accommodate for high submaximal oxygen?
A
- Moderate to vigorous - 60 mins 3+ days/week or 3 days/wk if more vigorous
- 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)
7
Q
Children and adolescents have lower absolute sweating rates compared with adults. What types of health considerations should a personal trainer take into consideration in order to accommodate for lower sweating rates?
A
Restrict vigorous exercise in hot, humid environments to less than 30 minutes and include frequent rest periods.
8
Q
Untrained children can improve their strength by an average of __-__% after 8 weeks of progressive resistance training.
A
30-40%
9
Q
Basic exercise guidelines for youth training:
What modes of exercise are safe for youth training?
A
Walking, jogging, running, games, activities, sports, water activity, resistance training
10
Q
Basic exercise guidelines for youth training: What frequency (how many times per week) is safe for youth training?
A
5-7 days/week
11
Q
Basic exercise guidelines for youth training: What intensity (for CRE) is safe for youth training?
A
Moderate-to-vigorous cardiorespiratory exercise training
12
Q
Basic exercise guidelines for youth training: What duration (how long per day/session) is safe for youth training?
A
60 minutes per day
13
Q
Basic exercise guidelines for youth training:
What types of movement assessments would a personal trainer conduct for youth?
A
- Overhead squats
- 10 push-ups (if 10 cannot be performed, do as many as can be tolerated)
- SL stance (if can tolerate, perform 3-5 SL squats per leg)
14
Q
What are the basic steps/guidelines when developing an Exercise program for youth:
A
- Assess for any movement deficiencies using a variety of movement assessments
- Assessments will help individualize phase 1 stabilization endurance training
- Progression to phases 2-5 should be decided on
- Maturity level
- Dynamic postural control (flexibility and stability)
- How they have responded to training up until this point
- Make it safe and fun!
15
Q
Basic exercise guidelines for youth training:
What resistance training guidelines are safe for youth training?
A
Reps: 8-12
Sets: 1-2
Intensity: 40-70%
Frequency: 2-3 days/week
Phases:
- Phase 1 of OPT should be mastered before moving on
- Phases 2-5 should be reserved for mature adolescents on the basis of dynamic postural control and a license physician’s recommendation
16
Q
What are some typical forms of degeneration associated with aging?
A
- Osteoporosis
- Arthritis (osteoarthritis)
- Low-back pain (LBP)
- Obesity
17
Q
List a normal physiologic change that occurs with age and what may cause it.
A
- Blood pressure tends to be higher at rest and during exercise (could be natural causes, could be disease, could be both)
- Arteriosclerosis may cause blood pressure to be higher
18
Q
What is arteriosclerosis?
A
Arteriosclerosis: a general terms that refers to the hardening (and loss of elasticity) of arteries
- Arteries are less elastic and pliable
- Result: greater resistance to blood flow = higher blood pressure
(normal with age)
19
Q
List 2 abnormal physiologic changes that occur with aging
A
- Atherosclerosis
- Peripheral vascular disease
20
Q
What is atherosclerosis? What is it typically caused by?
A
- Atherosclerosis: buildup of fatty plaques in arteries that lead to narrowing and reduced blood flow
- Caused largely by poor lifestyle choices (smoking, obesity, sedentary lifestyle etc)
- Restricts blood flow due to plaque buildup = increased resistance and higher blood pressure
(Abnormal with Age)
21
Q
What is peripheral vascular disease?
A
- Peripheral vascular disease: a group of diseases in which blood vessels become constricted or blocked, typically as a result of atherosclerosis
- Diseases caused by hypertension
- Refers to plaques that form in any peripheral artery, typically those in the lower leg
22
Q
What modes of exercise are safe for senior training?
A
- Stationary or recumbent cycling, aquatic exercise, or treadmill with handrail support
23
Q
What frequency (how many times per week) is safe for senior training?
A
- 3-5 days/wk of moderate-intensity activities or
- 3 days/wk of vigorous-intensity activities
24
Q
What intensity (for CRE) is safe for senior training?
A
- 40-85% of VO2 Peak
25
What duration (how long per day/session) is safe for senior training?
- 30-60 minutes / day or 8-10 minute bouts
26
What types of movement assessments would a personal trainer conduct for seniors?
- Push, pull, OH squat or
- Sitting and standing into a chair
- Single-leg balance
27
What resistance training guidelines are safe for senior training?
- 1-3 sets of 8-20 reps at 40-80% on 3-5 days/wk
- 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
28
Basic exercise guidelines for senior training:
| What flexibility training guidelines are safe for senior training?
- Self-myofascial release and static stretching
29
What are some special considerations to keep in mind when developing an exercise program and training 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 client is breathing normal manner and avoid holding breath as in a Valsalva maneuver
- If client cannot tolerate SMR or static stretching b/c of other conditions, perform slow rhythmic active or dynamic stretches
30
What is obesity? Give BMI ranges for the 3 categories of obesity.
- Obesity: The condition of subcutaneous fat exceeding the amount of lean body mass
- 30 - 34.99 = Obese - high risk of disease
- 35 - 39.99 = Obesity II - very high risk of disease
- ≥ 40 = Obesity III - extremely high risk of disease
31
What are some main causes of obesity?
Primary:
- Energy balance (too many calories consumed and too few expended)
Other causes:
- Complex medical issues
32
Adults who remain sedentary throughout their lifespan will lose approx. _lbs of muscle per decade and gain __lbs of fat per decade
- 5lbs
| - 15lbs
33
Average adults will experience __% reduction in fat-free mass (FFM) between the ages of 30 and 80
- 15% reduction
34
What is the main focus of obesity exercise training? How is it achieved?
Focus:
- Primarily on energy expenditure, balance, and proprioceptive training to help them expend calories and improve balance and gait mechanics
- By performing in a proprioceptively enriched environment (controlled, unstable) the body is forced to recruit more muscles to stabilize itself resulting in more calories potentially expended
35
What are the main goals for obesity exercise training?
Goals:
- Should expend 200-300 kcal/exercise session
- Minimum weekly goal: 1,250 kcal of energy expenditure from combined physical activity and exercise (progressively increase to 2,000 kcal/week)
36
Basic exercise guidelines for obese individuals:
| What modes of exercise are safe for obese clients?
- Low-impact or step aerobics (treadmill walking, rowing, stationary cycling and water activity)
- Dumbbells
- Cables
- Exercise tubing
- Swimming
- Cycle ergometer
- SMR with extreme caution in case client is not comfortable rolling or lying on floor
37
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Basic exercise guidelines for obese individuals:
What frequency (how many times per week) is safe for obese clients?
```
- At least 5 days per week
38
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Basic exercise guidelines for obese individuals:
What intensity (for CRE) is safe for obese clients?
```
- 60-80% of max heart rate. Use talk test to determine exertion
- Stage I cardiorespiratory training progression to stage II (intensities may be altered to 40-70% of max heart rate if needed)
39
```
Basic exercise guidelines for obese individuals:
What duration (how long per day/session) is safe for obese clients?
```
- 40-60 minutes per day or
| - 20-30 minutes sessions twice each day
40
Basic exercise guidelines for obese individuals:
| What types of movement assessments would a personal trainer conduct for obese clients?
- Push, pull, squat
| - Single-leg balance (if tolerated)
41
Basic exercise guidelines for obese individuals:
| What resistance training guidelines are safe for obese clients?
- 1-3 sets of 10-15 reps on 2-3 days per week
| - Phases 1 and 2 will be appropriate performed in a circuit-training manner (higher reps such as 20 may be used)
42
Basic exercise guidelines for obese individuals:
| What flexibility training guidelines are safe for obese clients?
- SMR (only if comfortable with client)
| - Flexibility continuum
43
What are some special considerations to keep in mind when developing an exercise program and training obese clients.
- 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
- May have other chronic diseases; in such cases a medical release should be obtained from the individual’s physician
44
What is diabetes?
- A chronic metabolic disorder caused by insulin deficiency, which impairs carbohydrate usage and enhances usage of fate and protein.
45
What is Type I diabetes? How/When does it develop?
- Type I: body does not produce enough insulin (insulin dependent)
- Specialized cells in the pancreas (beta cells) stop producing insulin, causing blood sugar levels to rise, resulting in hyperglycemia (high levels of blood sugar)
- Usually develops in childhood, teenagers and young adults
46
What happens if a person with Type I diabetes does not control blood glucose levels (via insulin injections or dietary carbs) before, during and after exercise?
- Blood sugar levels can drop rapidly causing hypoglycemia (low blood sugar) leading to weakness, dizziness, and fainting
- Insulin levels may need to be adjusted with exercise
because exercise increases the rate at which cells utilize glucose
47
How does an individual with diabetes control hyperglycemia (high levels of blood sugar)?
- To control hyperglycemia, individual must inject insulin to compensate for what the pancreas cannot produce.
48
What is Type II diabetes? How does it develop?
- Type II: cells become insulin resistant and body cannot respond normally to the insulin that is made (non-insulin dependent)
- Because cells are resistant to insulin (the insulin present in system cannot transfer adequate amounts of blood sugar into the cell) individual may be hyperglycemic (high blood sugar)
- Associated with obesity, specifically abdominal
49
Chronic hyperglycemia is associated with a number of diseases:
- Damage to kidneys
- Damage to heart
- Nerves
- Eyes
- Circulatory system
50
What are the goals of exercise training with Type I and Type II diabetes clients?
- Glucose control (type I and II)
| - Lose weight (type II)
51
Why is exercise effective to achieving glucose control (and potential weight loss) specific to diabetic clients?
- Exercise training is effective to achieve these goals (glucose control and weight loss) because of its similar action to insulin by enhancing the uptake of circulating glucose by exercising the skeletal muscle.
52
What are the benefits of exercise for diabetic clients?
Improves a variety of glucose measures:
- Tissue sensitivity
- Improved glucose tolerance
- Decrease in insulin requirements
53
List some physiologic considerations with diabetic clients in regard to exercise?
- Frequently associated with comorbidities (including cardiovascular disease, obesity, and hypertension)
- Exercise exerts an effect similar to that of insulin
- Hypoglycemia may occur several hours after exercise as well as during exercise
- Clients taking 𝛃-blocking medications may be unable to recognize signs and symptoms of hypoglycemia
- Exercise in excessive heat may mask signs of hypoglycemia
- Increased risk for retinopathy
- Peripheral neuropathy (loss of protective sensation in feet and legs) may increase risk for gait abnormalities and infection from foot blisters that may go unnoticed
54
Basic exercise guidelines for individuals with diabetes:
| What modes of exercise are safe for diabetic clients?
- Low-impact activities (cycling, treadmill walking, low-impact or step aerobics)
55
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Basic exercise guidelines for Individuals with diabetes:
What frequency (how many times per week) is safe for diabetic clients?
```
- 4-7 days per week
56
```
Basic exercise guidelines for individuals with diabetes:
What intensity (for CRE) is safe for diabetic clients?
```
- 50-90% of maximum heart rate
- Stage I cardiorespiratory training (may be adjusted to 40-70% of max heart rate if needed) progressing to stages II and III based on a physician’s approval
57
```
Basic exercise guidelines for individuals with diabetes:
What duration (how long per day/session) is safe for diabetic clients?
```
- 20-60 minutes
58
Basic exercise guidelines for individuals with diabetes:
| What types of movement assessments would a personal trainer conduct for diabetic clients?
- Push, pull, squat
| - Single-leg balance or single-leg squat
59
Basic exercise guidelines for individuals with diabetes:
| What resistance training guidelines are safe for diabetic clients?
- 1-3 sets of 10-15 reps 2-3 days/week
| - Phases I and 2 of OPT model (higher reps such as 20 may be used)
60
Basic exercise guidelines for individuals with diabetes:
| What flexibility training guidelines are safe for diabetic clients?
- Flexibility continuum
61
What are some special considerations to keep in mind when developing an exercise program and training diabetic clients?
- Make sure the client has appropriate footwear and have the client or physician check feet for blisters or abnormal wear patterns
- Advise client to keep a snack (quick source of carbs) 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
62
What is hypertension?
- Consistently elevated arterial blood pressure, which, if sustained at high enough level, is likely to induce cardiovascular or organ damage
- Aka. high blood pressure
63
What are the BP ranges for hypertensive and prehypertensive people.
Hypertensive:
- Resting systolic: ≥ 140 mm Hg;
- Resting diastolic: ≥ 90 mm Hg
Prehypertensive:
- Resting systolic: between 120 and 135 mm Hg;
- Resting diastolic: between 80 and 85 mm Hg
64
What are the causes of hypertension?
- Smoking
- Diet high in fat (particularly saturated fat)
- Excess weight
65
What are the risks associated with hypertension?
- Stroke
- Cardiovascular disease
- Chronic heart failure
- Kidney failure
66
What modes of exercise are safe for hypertension clients?
- Stationary cycling
- Treadmill walking
- Rowers
67
What frequency (how many times per week) is safe for hypertensive clients?
- 3-7 days per week
68
What intensity (for CRE) is safe for hypertension training?
- 50-85% of maximal heart rate
| - Stage I cardiorespiratory training progressing to stage II (intensities may be altered to 40-70% of max HR if needed)
69
What duration (how long per day/session) is safe for hypertension clients?
- 30-60 minutes
70
What types of movement assessments would a personal trainer conduct for hypertensive clients?
- Push, pull, OH squat
| - Single-leg balance (squat if tolerated)
71
What resistance training guidelines are safe for hypertension clients?
- 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 sec for isometric and concentric portions (ex 4/1/1 instead of 4/2/1)
- Use circuit or PHA weight training as an option, with appropriate rest intervals
72
What flexibility training guidelines are safe for hypertension clients?
- Static and active in a standing or seated position
73
What are some special considerations to keep in mind when developing an exercise program and training hypertensive 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 action
- Perform exercises in a standing or seated position
- Allow client to stand up slow to avoid possible dizziness
- Progress client slowly
74
What is the Valsalva maneuver?
- A maneuver in which a person tries to exhale forcibly with a close 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.
75
What causes coronary heart disease?
Primary Cause:
- Poor lifestyle choices (primarily cigarette smoking, poor diet, and physical inactivity)
Other causes:
- Caused by atherosclerosis (plaque formation) which leads to narrowing of the coronary arteries and ultimately angina pectoris (chest pain), myocardial infarction (heart attack), or both
76
What is the emphasis for treatment of coronary heart disease?
- Improving the health of the internal lining of the coronary artery called plaque “stabilization.”
77
List the benefits of exercise for coronary heart disease.
- Lower risk of mortality
- Increased exercise tolerance, muscle strength
- Reduction of angina and heart failure symptoms
- Improved physiological status and social adjustment
- Heart disease may even be slowed (or even reversed) when a multi-factor intervention program of intensive education, exercise, counseling, and lipid-lowering medications are used (as appropriate)
78
When a client has coronary heart disease, peak oxygen uptake (as well as ventilatory threshold) is often reduced because of the compromised cardiac pump and peripheral muscle deconditioning. What type of intensity and aerobic training guidelines should you use with the client?
Intensity:
Low intensity to start and based on recommendations provided by a certified exercise physiologist or physical therapist with specialty training.
Aerobic training guidelines:
- At minimum 20-30 minutes 3-5 days/wk at 40-85% of maximal capacity, but below upper safe limits prescribed by a physician
79
What is the weekly caloric guide for a client with coronary heart disease?
Weekly caloric goal:
| - 1,500-2,000 kcal is usually recommended, progressing as tolerable to maximize cardio protection
80
When can a client with coronary heart disease use resistance training as a mode of exercise? What type of training format is recommended?
- May be started after the patient has been exercising asymptomatically comfortably for >3 months in the aerobic exercise program
- Circuit training format is recommended:
- 8-10 exercises, 1-3 sets of 10-20 reps/exercise
- emphasizing breathing control and rest as needed between sets
81
What modes of exercise are safe for CHD clients?
- Large muscle group activities: stationary cycling, treadmill walking, or rowing
82
What frequency (how many times per week) is safe for CHD clients?
- 3-5 days per week
83
What intensity (for CRE) is safe for CHD clients?
- 40-85% of maximal heart rate reserve
- Talk Test may be appropriate as medications may affect heart rate
- Stage I cardiorespiratory training
84
What duration (how long per day/session) is safe for CHD clients?
(30-60 minutes total)
- 5-10 min warm-up
- 20-40 minutes of exercise
- 5-10 minute cool-down
85
What types of movement assessments would a personal trainer conduct for CHD Clients?
- Push, pull, OH squat
| - Single-leg balance (squat if tolerated)
86
What flexibility training guidelines are safe for CHD clients?
- Static and active in a standing or seated position
- Examples for core: prone iso-abs (plants) on an incline, standing torso cable iso-rotations, or cobras in a standing position (2-leg or single-leg)
87
What resistance training guidelines are safe for CHD training?
- 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 sec for isometric and concentric portions (ex 4/1/1 instead of 4/2/1)
- Use circuit or PHA weight training as an option, with appropriate rest intervals
88
What are some special considerations to keep in mind when developing an exercise program and training coronary heart disease clients?
- 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 over-grip weights or clench fists when training
- Perform exercises in a standing or seated position
- Allow client to stand up slow to avoid possible dizziness
- Progress client slowly
89
What is osteopenia? What is it a precursor for?
- A decrease in the calcification or density of bone as well as reduced bone mass.
- Bone mineral density (BMD) is lower than normal
- Precursor for osteoporosis
90
What is osteoporosis? How many types are there?
- 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.
- Disease of bones in which BMD is reduced, the bone microstructure is disrupted, and the actual proteins in bone are altered.
- Two types
91
What is type I osteoporosis associated with and attributable to? Is it treatable?
- Primary type of osteoporosis
Associated with:
- Normal aging;
- Most prevalent in postmenopausal women due to deficiency in estrogen
Attributable to:
- A lower production of estrogen and progesterone (both regulate the rate at which bone is lost)
- Characterized by an increase in bone resorption (removal of old bone) with a decrease in bone remodeling (formation of new bone) which lead to a decrease in BMD
- Treatable
92
What is type II osteoporosis caused by? Is it treatable?
- Secondary type
- Caused by certain medical conditions (and diseases) or medications that can disrupt normal bone reformation (also includes alcohol abuse and smoking)
- Treatable
93
Osteoporosis usually affects the neck of the femur, lumbar vertebrae and hip.
Chronic vertebral fractures may result in significant low-back pain. What are some resistance training guidelines/recommendations for clients with osteopenia or osteoporosis?
- For clients with osteopenia (and not contraindications to exercise), resistance training is recommended to build bone mass
- Loads >75% of 1RM have been shown to improve bone density, but the client must be properly progressed to be able to handle these loads
- Circuit-training format is recommended: 8-10 exercises, 1 set of 8-12 reps/exercise with rest as needed between sets
94
What modes of exercise are safe for osteoporosis/osteopenia clients?
- Treadmill with handrail support
- For clients with severe osteoporosis, exercise modality should be shifted to water exercise to reduce the risk of loading fracture.
- If aquatic exercise is not feasible, use other weight-supported exercise, such as cycling, and monitor signs and symptoms
95
What frequency (how many times per week) is safe for osteoporosis/osteopenia clients?
- 2-5 days per week
96
What intensity (for CRE) is safe for osteoporosis/osteopenia clients?
- 50-90% of maximal heart rate reserve
| - Stage I cardiorespiratory training progressing to stage II
97
What duration (how long per day/session) is safe for osteoporosis/osteopenia clients?
- 20-60 minutes/day
| - 8-10 minute bouts
98
What types of movement assessments would a personal trainer conduct for osteoporosis/osteopenia clients?
- Push, pull, OH squat
| - Sitting and standing into a chair (if tolerated)
99
What flexibility training guidelines are safe for osteoporosis/osteopenia clients?
- Static and active stretching
100
What resistance training guidelines are safe for osteoporosis/osteopenia?
- 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
101
What are some special considerations to keep in mind when developing an exercise program and training clients with osteoporosis/osteopenia?
- 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 client is breathing in normal manner and avoid holding breath as in a Valsalva maneuver
102
What other recommendations can a personal trainer make to clients with osteoporosis/osteopenia?
- Reinforce other lifestyle behaviors that will optimize bone health, including smoking cessation, reduced alcohol intake, and increase dietary calcium intake
103
What is arthritis?
- Chronic inflammation of the joints
104
What is osteoarthritis? Where is it commonly affected?
Osteoarthritis:
- Arthritis in which cartilage becomes soft, frayed, or thins out, as a result of trauma or other conditions
- Lack of cartilage creates a wearing on the surfaces of articulating bones, causing inflammation and pain at the joint
Commonly affected:
- Hands, knees, hips, and spine
105
What is rheumatoid arthritis? Where is it commonly affected?
Rheumatoid arthritis:
- Arthritis primarily affecting connective tissues, in which there is a thickening of articular soft tissues, and extension of synovial tissues over articular cartilages that have become eroded
- The body’s immune system mistakenly attacks its own tissue (joints or organs in this case) leading to pain and stiffness
Commonly affected:
- Hands, feet, wrists, and knees
106
What medications are associated with arthritis? What risk might they cause?
- Oral corticosteroids: clients may have osteoporosis, increase body mass, and if a history of GI bleeding, anemia.
- Steroids may also increase fracture risk
107
What modes of exercise are safe for arthritis clients?
- Treadmill walking, stationary cycling, rowers, and low-impact or step aerobics
108
What frequency (how many times per week) is safe for arthritis clients?
- 3-5 days per week
109
What intensity (for CRE) is safe for arthritis clients?
- 60-80% of maximal heart rate reserve
| - Stage I cardiorespiratory training progressing to stage II (may be reduced to 40-70% of max heart rate if needed)
110
What duration (how long per day/session) is safe for arthritis clients?
- 30 minutes
111
What types of movement assessments would a personal trainer conduct for arthritis clients?
- Push, pull, OH squat
| - Single-leg balance or single-leg squat (if tolerated)
112
What flexibility training guidelines are safe for arthritis clients?
- SMR, static and active stretching
113
What resistance training guidelines are safe for arthritis?
- 1-3 sets of 10-20 repetitions 2-3 days per week
- Phases 1 of OPT Model with reduced repetitions (10-12)
- May use a circuit or PHA training system
114
What are some special considerations to keep in mind when developing an exercise program and training clients with arthritis?
- Avoid heavy lifting and high reps
- Stay in pain-free ranges of motion
- Only use SMR if tolerated by client
- There may be a need to start out with only 5 minutes of exercise and progressively increase, depending on severity of conditions
115
Define cancer.
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 a patient unless adequately treated
116
Medications associated with cancer and effects on exercise:
- Peripheral nerve damage
- Cardiac and pulmonary problems
- Skeletal muscle myopathy (muscle weakness and wasting)
- Anemia (as well as frequent nausea)
- Treatments frequently result in a diminished quality of life
117
List some physiologic considerations a personal trainer needs to take into consideration with clients with cancer:
Fatigue and weakness, if common:
- Aerobic exercise should be done at low-moderate intensity (40-50% of peak capacity),
- 3-5 days/wk using typical aerobic modes (treadmill, elliptical trainer, cycle, depending on patient preference)
- Avoid higher-intensity training during periods of cancer treatment
- Excessive fatigue may result in overall diminished activity
- Diminished immune function
- Decreased lean muscle mass
118
What modes of exercise are safe for clients with cancer?
- Treadmill walking, stationary cycling, rowers, and low-impact or step aerobics
119
What frequency (how many times per week) is safe for clients with cancer?
- 3-5 days per week
120
What intensity (for CRE) is safe for clients with cancer?
- 50-70% of maximal heart rate reserve
| - Stage I cardiorespiratory training progressing to stage II (may be reduced to 40-70% of max heart rate if needed)
121
What duration (how long per day/session) is safe for clients with cancer?
- 15-30 minutes
122
What types of movement assessments would a personal trainer conduct for clients with cancer?
- Push, pull, OH squat
| - Single-leg balance (if tolerated)
123
What flexibility training guidelines are safe for clients with cancer?
- SMR, static and active stretching
124
What resistance training guidelines are safe for clients with cancer?
- 1-3 sets of 10-15 repetitions 2-3 days per week
- Phases 1 and 2 of OPT Model
- May use a circuit or PHA training system
125
What are some special considerations to keep in mind when developing an exercise program and training clients with cancer?
- Avoid heavy lifting in the 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 out with only 5 minutes of exercise and progressively increase, depending on the severity of conditions and fatigue
126
Postnatal women should be encourages to reeducate posture, joint alignment, muscle imbalances, stability, motor skills, and recruitment of the deep core stabilizer such as the _________ ________, ________ _______, and ______ _____ ___________.
- Transverse abdominis,
- Internal oblique
- Pelvic floor musculature
127
For women who are pregnant or postnatal, screen carefully for potential contraindications to exercise. What are some contraindications to look for / be mindful of with clients who are pregnant or postnatal?
- Persistent bleeding 2nd to 3rd trimester
- Medical documentation of incompetent cervix
- Intrauterine growth retardation
- Pregnancy-induced hypertension
- Preterm rupture of membrane
- Preterm labor during current or prior pregnancy
128
Even in the absence of exercise, pregnancy may increase metabolic demand by ___ kcal per day to maintain energy balance
- 300 kcal
129
What modes of exercise are safe for pregnant/postnatal clients?
- Low-impact or step aerobics that avoid jarring motions, treadmill walking, stationary cycling, and water activity
130
What frequency (how many times per week) is safe for pregnant/postnatal Clients?
- 3-5 days per week
131
What intensity (for CRE) is safe for pregnant/postnatal clients?
- Stage I cardiorespiratory training and only enter Stage II on a physician’s advice
132
What duration (how long per day/session) is safe for pregnant/postnatal clients?
- 15-30 minutes per day.
- They may be a need to start out with only 5 minutes of exercise and progressively increase to 30 mins, depending on severity of conditions
133
What types of movement assessments would a personal trainer conduct for pregnant/postnatal clients?
- Push, pull, OH squat
| - Single-leg balance or single-leg squat
134
What flexibility training guidelines are safe for pregnant/postnatal clients?
- SMR, static and active stretching
135
What resistance training guidelines are safe for pregnant/postnatal clients?
- 2-3 days per week using light loads at 12-15 reps
- Phases 1 and 2 of OPT Model (use only phase 1 after first trimester)
- Resistance training (if cleared by DR):
- a circuit-training format is recommended
- 1-3 sets
- 12-15 reps per exercise
- Emphasize breathing control and rest as needed in between sets
136
What are some special considerations to keep in mind when developing an exercise program and training pregnant/postnatal clients?
- Avoid exercises in a prone (on stomach) or supine (on back) 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
- Advise clothing that will dissipate heat easily during exercise
- Postpartum exercise should be similar to pregnancy guidelines, as the physiologic changes that occur during pregnancy may persist for up to 6 weeks.
137
What is restrictive lung disease? What can cause it?
- The condition of a fibrous lung tissue, which results in a decreased ability to expand the lungs
- Can be caused by fractured ribs, a neuromuscular disease, or even obesity
138
What is chronic obstructive lung Disease? What can cause it?
- The condition of altered airflow through the lungs, generally caused by airway obstruction as a result of mucus production
- Lung tissue may be normal, but airflow is restricted
Causes:
- Characterized by chronic inflammation (caused primarily by smoking, although asthma cases may be caused by environmental irritants) and airway obstruction via mucus production
139
List some types of chronic obstructive lung disease.
Types include:
- Asthma
- Chronic bronchitis
- Emphysema
- Cystic fibrosis (genetic disorder)
140
Upper extremity exercise may result in the early onset of dyspnea and fatigue than expected when compared with lower extremity exercise in clients with lung disease. What are some ways to avoid the early onset of dyspnea and fatigue?
- 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 exercise
- 1 set
- 8-15 reps per exercise
- Emphasize breathing control and rest as needed between sets
141
What modes of exercise are safe for clients with chronic lung disease?
- Treadmill walking, stationary cycling, steppers, and elliptical trainers
142
What frequency (how many times per week) is safe for clients with chronic lung disease?
- 3-5 days per week
143
What intensity (for CRE) is safe for clients with chronic lung disease?
- 40-60% of peak work capacity (what’s the difference between that and maximum heart rate reserve?)
- Stage I cardiorespiratory training
144
What duration (how long per day/session) is safe for clients with chronic lung disease?
- Work up to 20-45 minutes
145
What types of movement assessments would a personal trainer conduct for clients with chronic lung disease?
- Push, pull, OH squat
| - Single-leg balance or single-leg squat
146
What flexibility training guidelines are safe for clients with chronic lung disease?
- SMR, static and active stretching
147
What resistance training guidelines are safe for clients with chronic lung disease?
- 1 set of 8-15 repetitions 2-3 days per week
- Phase 1 of OPT Model
- PHA (peripheral heart action) training system recommended
148
What are some special considerations to keep in mind when developing an exercise program and training clients with chronic lung disease?
- Upper body exercises cause increased dyspnea (shortness of breath) and must be monitored
- Allow for sufficient rest between exercises
149
What is intermittent claudication?
- The manifestation of the symptoms caused by peripheral arterial disease
150
What is peripheral vascular disease?
- Commonly used to describe the activity-induced symptoms that characterize this disease
151
What is peripheral arterial disease (PAD)?
- A condition characterized by narrowing of the major arteries that are responsible for supplying blood to the lower extremities
152
Resistance training may improve overall physical function, but may not address limitations of PAD. What is the best type of Resistance Training, how would it be achieved, and what are the typical guidelines (intensity) for a client with PAD?
- Resistance exercise should be complementary to but not substituted for aerobic exercise
- A Circuit-training format is recommended
- 8-10 exercises
- 1-3 sets
- 8-12 reps per exercise, progressing up to 12-20 reps
- An intermittent format of exercise may be necessary with intensity guided by pain tolerance
- Typical guidelines suggest exercise into moderate to severe discomfort, rest until subsided, and repeat until total exercise time is achieved (20-30 minutes)
- Always screen for comorbidities
153
What modes of exercise are safe for clients with peripheral arterial disease?
- Treadmill walking is preferred, stationary cycling, steppers, and elliptical trainers
154
What frequency (how many times per week) is safe for clients with peripheral arterial disease?
- 3-5 days per week working up to every day
155
What intensity (for CRE) is safe for clients with peripheral arterial disease?
- 50-85% of maximal heart rate
156
What duration (how long per day/session) is safe for clients with peripheral arterial disease?
- Work up to 20-30 minutes
157
What types of movement assessments would a personal trainer conduct for clients with peripheral arterial disease?
- Push, pull, OH squat
| - Single-leg balance or single-leg squat
158
What flexibility training guidelines are safe for clients with peripheral arterial disease?
- Static and active stretching
159
What resistance training guidelines are safe for clients with peripheral arterial disease?
- 1-3 sets of 8-12 repetitions 2-3 days per week and slowing creasing up to 12-20 reps
- Phase 1 of OPT Model
160
What are some special considerations to keep in mind when developing an exercise program and training clients with peripheral arterial disease?
- Allow for sufficient rest between exercises
- Workout may start with 5-10 minutes of activity and slowly progress client to 20-30 minutes
- PAD frequently results in decreased aerobic capacity and endurance
- Focus on aerobic exercise activities, with an emphasis on walking
- Patients with coexisting coronary artery disease: do not exceed established heart rate upper limit (usually this limit is established from a walking test, in which leg pain is the limiting factor)
- Switching modalities so that leg pain will not limit exercise may result in a higher and possibly inappropriate cardiac workload
- If possible, a continuous format of exercise using walking is preferred
