Exercise ScienceTraining

Special Populations

Training Special PopulationsSpecial Populations – individuals that have unique

needs or concerns physically, due to disease, injury or lifestyle conditions.

These individuals will NEED accommodations and/or adjustments made to the standard exercise guidelines and recommendations to challenge but not overwhelm.

Key Words: Accommodate & Adjust

Training Special Populations

Cardiovascular Disorders Hyperlipidemia Hypertension Arteriosclerosis Coronary (Heart) Disease Cerebral Vascular Accident (Stroke) Peripheral Vascular Disease (PVD)

Training Special PopulationsHyperlipidemia (high cholesterol)

Lipid is the scientific term for fats in the blood. At proper levels, lipids

perform important functions in your body,

but can cause health problems if they are

present in excess. The term hyperlipidemia means high lipid levels. Hyperlipidemia includes several conditions,

but it usually means that you have high

cholesterol and high triglyceride levels. High lipid levels can speed up a process called

atherosclerosis, and heart disease

Training Special PopulationsHyperlipidemia Exercise Guidelines

Eat a diet low in total fat, saturated fat, and cholesterol. Increase consumption of high-fiber foods such as fruits, vegetables, beans, and whole grains. If you are overweight, lose weight. Exercise regularly (cardiovascular training 1st) Physician Release

Training Special PopulationsHypertension

Systolic 160mmHg or greater, Diastolic 90 mmHg or greater Over 50 million people have elevated blood pressure Hypertensive individuals have a 3 to 4 times greater risk of developing heart disease and 7 time greater risk of having a stroke Typically caused by narrowing of the arteries

Training Special PopulationsHypertension Exercise Guidelines Obtain a Physician Release No Valsalva Maneuver Aerobic Activities (1st) May need to use alternate

methods of assessing intensity May appropriate of monitor

and record BP during training

Training Special PopulationsHypertension Exercise Guidelines Stop training immediately if

ANY abnormal symptoms arise Muscular training if used should

be muscular conditioning Be aware of orthostatic Hypotension No Isometric Activities Frequency 4+ sessions/week Duration of 30 to 60mins Intensity – Low

Training Special PopulationsCerebral Vascular Accident (stroke)

Training Special PopulationsCerebral Vascular Accident (stroke)

Training Special PopulationsCerebral Vascular Accident Exercise Guidelines Same guidelines as Hypertension Obtain Physician Release Frequency – 4+ sessions/week Intensity – Low Time – 30 to 60 mins Type – Aerobic Activities (1st)

Muscular conditioning if at all

Training Special PopulationsArteriosclerosis A disease affecting the arterial blood vessel.

It is commonly referred to as a "hardening"

of the arteries. It is caused by the formation

of multiple plaques within the arteries. increases your risk of heart disease,

stroke, and other vascular diseases.

Training Special Populations

Coronary (heart) Disease

Plaque often narrows a coronary artery

so that the heart does not get enough blood.

This slowing of blood flow causes

chest pain, or angina.

Training Special PopulationsCoronary (heart) Disease

If plaque completely blocks blood flow, it may cause a heart attack (myocardial infarction) or a fatal rhythm disturbance (sudden cardiac arrest).

A major cause of death and disability, coronary heart disease claims more lives in the United States than the next 7 leading causes of death combined.

Training Special Populations

Exercise Guidelines for CHD & Arteriosclerosis

Obtain a Physician Release Network with the individuals

Cardiologist Frequency – 3 to 5 sessions/week Intensity – Low as per tolerance Time – 20 to 30 min continuous Type – Aerobic Activities

Training Special PopulationsPeripheral Vascular Disease The blood vessels outside the heart

and brain begin to develop arteriosclerosis. It's often a narrowing of vessels

that carry blood to the legs, arms, stomach

or kidneys. 20 times more common in Diabetics Intermittent claudication (weakness, pain) Painful!!!

Training Special PopulationsPeripheral Vascular Disease Exercise Guidlines Avoid training in the cold

(air or water) encourages vasoconscriction Interval Training – frequent rests periods Avoid Blistering to the feet Initially non-weight bearing Frequency – Daily to tolerance Intensity – Low to High (claudication Scale) Time 30 to 40 min working to continuous Type – Aerobic (non-impact)

Training Special Populations

Metabolic Disorders Hypoglycemia Insulin Dependant Diabetes Mellitus Non-Insulin Dependant Diabetes Mellitus Gestational Diabetes

Training Special PopulationsHypoglycemia The pancreas sends out too much insulin and the blood sugar

plummets below the level necessary to maintain well-being.Since all the cells of the body, especially the brain cells, use glucose for fuel, a blood glucose level that is too low starves the cells of needed fuel, causing both physical and emotional symptoms

Symptoms:fatigue heart palpitations insomnia dizziness faintness blurred vision headaches

Training Special PopulationsHypoglycemia & Exercise Guidelines Exercise is an important component in the management of

hypoglycemia because it is a great metabolic booster. Increases insulin sensitivity Lowers insulin needs Improves glucose tolerance. Frequency – 3 to 5 sessions/week Intensity – As per tolerance Time – work towards 30+ mins continuous Type – Aerobic initially

Training Special PopulationsInsulin Dependant Diabetes Mellitus Juvenile or Type I Diabetes The body (pancreas) does not produce insulin Insulin must be introduces externally Diabetics are at greater risk for kidney failure, nerve damage, eye problems & heart disease Prolonged and frequent elevation of blood sugars can damage capillary beds, which lead to poor circulation Prone to infections

Training Special PopulationsNon-Insulin Dependant Diabetes Mellitus Adult onset or Type II Diabetes Body Produces insulin, reduced

sensitivity Most Common 90% of all

diabetics Lifestyle – high sugar diets,

overweight Reversible – by lifestyle modification

Training Special PopulationsGestational Diabetes Mellitus

A form of Type II diabetes Manifests during pregnancy Ceases post gestation Prone to Type II diabetes

in later life

Training Special PopulationsDiabetes Exercise Guidelines Check glucose levels frequently Always have a rapid acting

carbo snack available Avoid exercising during peak

insulin periods Do not inject insulin into muscles

that will be trained Take care of their feet

Training Special PopulationsDiabetes Exercise Guidelines Frequency – IDDM: 5 to 7 sessions/week

NIDDM: 4 to 5 sessions/week Intensity – IDDM: 50% to 60% HRR

NIDDM: 60% to 70% HRR Time – IDDM: 20 to 30 min continuous

NIDDM: 40 to 60 min continuous Type – Aerobic Activities

Training Special PopulationsPulmonary Disorders

Asthma Bronchitis (COPD) Emphysema (COPD)

Training Special PopulationsAsthma Reactive Airway Disease

Allergies, exercise, infections,

stress, environmental irritants Shortness of Breaths, coughing

& Wheezing Caused by: Constriction of Smooth

muscle around airways

Swelling of mucosal cells

Increase in mucous Approx 80% of asthmatics –exercise induced

Training Special PopulationsAsthma Exercise Guidelines Pre-exercise medicine Carry inhaler Drink plenty of fluids Extend Warm-up & Cool down Avoid training in extreme

environment conditions (cold, pollen, heat) Freqency – 3 to 4 session/week Intensity – Initially Low to tolerance Time – 25 to 45 min continuous Type – Aerobic (1st)

Training Special PopulationsBronchitis (COPD) Form of Chronic Obstruction Pulmonary

Disorder Inflammation of the bronchi, the main

air passages to the lungs, it generally follows

a viral respiratory infection. Symptoms include; coughing, shortness

of breath, wheezing and fatigue.

Training Special PopulationsEmphysema (COPD) lung disease that involves

damage to the air sacs (alveoli)

in the lungs. The air sacs are unable to

completely deflate, and are

therefore unable to fill with

fresh air to ensure adequate

oxygen supply to the body.

Training Special PopulationsBronchitis & Emphysema (COPD) Exercise

Guidelines May not see improvements in pulmonary function Benefits – decreased stress, weight, anxiety, increased functionality of

daily duties Unstable COPD physician release Avoid upper body exercises Frequency – 4 to 5 sessions/week Intensity – low Time – 20 to 30 mins (continuous) Type – Aerobic/Dynamic activities

Training Special PopulationsBone or Joint Disorders

Osteoarthritis Rheumatoid Arthritis Osteoporosis Chronic Low Back Pain

Training Special PopulationsOsteoarthritis most common joint disorder The chronic disease causes the cushioning (cartilage) between the bone joints to wear away, leading to pain and stiffness. It can also cause new pieces of bone, called bone spurs, to grow around the joints. Causes: primarily related to aging. However, metabolic, genetic, chemical, and mechanical factors play a role The cartilage of the affected joint becomes rough and wears down (degenerates). As the disease gets worse, the cartilage disappears and the bone rubs on bone. Bony spurs usually develop around the joint.

Training Special PopulationsRheumatoid Arthritis Chronic disease that causes

inflammation of the joints and surrounding tissues. Cause is unknown It is considered autoimmune disease RA can occur at any age. It usually occurs in people between 25 and 55. Women are affected more often than men.

Training Special PopulationsArthritis Exercise Guidelines Low impact activities Extend Warm-up and Cool-downs Be able to modify activity during session Train full ROM Emphasize correct Biomechanics More limited due to ROM than CV Frequency – 4 to 5 session/week Intensity – Low to tolerance Time – Initially 10 to 15 min bouts Type – Aerobics, Calisthenics

Training Special PopulationsOsteoporosis The thinning of bone tissue and loss of bone density over time. Most common type of bone disease The leading causes are a drop in estrogen in women at the time of menopause, and a drop in testosterone in men. Women, especially those over the age of 50, get osteoporosis more often than men. Osteoporosis is the most common type of bone disease. There are currently an estimated 10 million Americans suffering from osteoporosis, as well as another 18 million who have low bone mass.

Training Special PopulationsOsteoporosis Exercise Guidelines Weight Bearing Activities, promotes greater bone deposition Avoid Ballistic Activities , Jumping,Running, etc. Avoid spinal flexion, wood floors, abducting & adducting hips Frequency – 4 to 5 sessions/week Intensity – Low (40% to 50% HRR) Time – 30 to 60 mins continuous (long warm-up) Type – Aerobic (weight bearing) training, muscular conditioning training

Training Special PopulationsLow Back Pain Low back pain is the #2 leading

reason that Americans see their

doctor -- second only to colds

and flus. Most back injuries occur at work 85% of chronic low back pain

is a result of weak abdominal muscles

and poor flexibility of low back and

hamstrings.

Training Special PopulationsLow Back Exercise Guidelines Always proper mechanical alignment Neutral pelvic alignment Avoid low back hyperextension Proper warm-up & cool down Frequency – 4 to 5 sessions/week Intensity – Low (40% to 50% HRR) Time – 30 to 60 mins continuous

(long warm-up) Type – Aerobic (weight bearing)

training, muscular conditioning training

Training Special PopulationsMiscellaneous Disorders

Cancer Aging Obesity (Over Weight) Children

Training Special PopulationsCancer Cancer develops when cells in a part of the body begin to grow out of control. Although there are many kinds of cancer, they all start because of out-of-control growth of abnormal cells Cancer cells continue to grow and divide, they are different from normal cells. Instead of dying, they outlive normal cells and continue to form new abnormal cells. Cancer cells develop because of damage to DNA

Training Special PopulationsCancer Often, cancer cells travel to other parts of the body where they begin to grow and replace normal tissue.

This process is called metastasis Not all tumors are cancerous. Cancer is the second leading cause of death in the United States. Half of all men and one third of all women in the United States will develop cancer during their lifetimes. The risk of developing most types of cancer can be reduced by changes in a person's lifestyle

Training Special PopulationsCancer Exercise Guidelines Adjust activity to individual’s capacity

(physical, nutritional, treatment) Exercise does not CURE cancer

but it can help improve quality of life Exercise can be a factor to assist

in prevention of Cancer Frequency – as per status Intensity – as per status Time – as per status Type – as per status

Training Special PopulationsAging By 2030, the number of older Americans will have more than doubled to 70 million, or one in every five Americans. Regular physical activity greatly reduces a person's risk from dying of heart disease, and decreases the risk for colon cancer, diabetes, and high blood pressure. Physical activity also helps to control weight; contributes to healthy bones, muscles, andjoints; helps to relieve the pain of arthritis; reduces symptoms of anxiety anddepression; and can decrease the need for hospitalizations, physician visits, andmedications. People tend to be less active as they age.

Training Special Populations By age 75, about one in three men and one in two women do not engage in ANY physical activity. The heart muscle becomes a less efficient pump, working harder to pump the same amount of blood through your body. Also, your blood vessels become less elastic & possibly harden. Bones shrink in size and density. Gradual loss of density weakens your bones and makes them more susceptible to fracture. Muscles, tendons and joints generally lose some strength and flexibility.

Metabolism generally slows

Training Special PopulationsAging Exercise Guidelines Physical activity does not need to be strenuous to bebeneficial; people of all ages benefit from moderate physical activity. Obtain a Physician Release Emphasize Full ROM Frequency – 4 to 5 Sessions/week Intensity – Moderate as per status Time – 30 to 60 mins (include an extended warm-up and cool-down) Type – Aerobic activities, muscular conditioning, flexibility exercises, calisthenics

Training Special PopulationsObesity (Over Weight) On any given day 1 out of every 4 Americans is on a diet Among adults aged 20–74 years the prevalence of obesity increased

from 15.0% (in the 1976–1980 survey) to 32.9% (in the 2003–2004 survey).

Weight Management Industry $40 billion 95% of those who lose weight will be

unsuccessful in keeping it off.

Training Special PopulationsObesity (Over Weight) May Lead to Hypokinetic disorders Hypertension Hyperlipidemia (for example, high total cholesterol or high levels of triglycerides) Type 2 diabetes Coronary heart disease Stroke Gallbladder disease Osteoarthritis Sleep apnea and respiratory problems Some cancers (endometrial, breast, and colon)

Training Special PopulationsObesity (Over Weight) Exercise Guidelines Moderation 1 to 2 pounds /week Lifestyle Change Exercise – Appetite Suppressant Emotional Concerns Be sensitive to mobility, balance, coordination, & fitness levels Frequency – 5 to 6 sessions/week Intensity – Low (40% -50% HRR) progress slowly Time – 30 to 60min continuous Type – Aerobic Activities, Muscular Conditioning initially

Training Special PopulationsChildren Children are NOT “mini” adults Child Definition

Birth – 1 year

1 year -3 years

4 years – 5 years

6 years – 12 years

13 years – 18years Childhood Obesity epidemic Overweight children are more likely to be overweight adults.

Training Special PopulationsChildren Exercise Guidelines Make your activities FUN Develop Coordination Make your activities FUN Improve Cv System Make your activities FUN Improve muscular conditioning Make your activities FUN Frequency – Daily Activity Intensity – challenge not overwhelm Time – at least 30 mins/bout (multiple bout/day) Type – Activities to promote Cv, muscular conditioning, coordination & agility