Define - Special Population -

A special population may be defined in terms of exercise on a group with a special medical condition who may require expertise and supervision to overcome that medical situation. Other special populations may just need to improve their skill level and knowledge or increase awareness and social interaction of conditioning by participating in a regular physical activity.

Example : Diabetes, hypertension, Arthritis older Adults etc.

Benefits of exercise for individual with diabetes :

a) Has shown improvement in glucose tolerance and overall metabolism.
b) Improvement in over all blood glucose control, cholesterol and strength.
c) Exercise like aerobic or strength training has an insulin like affect on glucose uptake into cells.

Benefits Of PACE Program :

PACE : (People with Arthritis can exercise).

a) Maintaining range of motion for all of its participants.
b) Clearing waste products that accumulate in joints through muscle toning.
c) ROM (Range of Motion) exercise participant can perform there three times or more during a given day.
c) Increasing muscle tone through resistance training with external work loads decreases to a minimum the fibromyalgia component and some of the suffering.
e) Using exercise as a social interaction to guard against depression, which is one of the major reasons arthritis patients deteriorate in health.

Two Types Of Arthritis:

a) Osteoarthritis : is a non-systematic disease and usually attacks on joint in the body.
b) Rheumotoid Arthritis : is a systemic disease that like type 1 diabetes, has an autoimmune etiology.

Three Catogries Of Seniors:

a) 50-65 years old - May participate in most moderate weight training routines with only slight modifications (joint problem, decreased range of motion, any cardiovascular abnormalities)

b) 65-80 years old - For thin group modified programs should be modified and based on medical recommendation, ROM limitations, and signs of fatigue, initial muscle tone and joint pain.

c) 80 years old and up : For this age level, low exertion level should be monitored and emphasis placed on individual muscle group strength, overall posture and strength enhancement to avoid injury.

Three Type Of Hypertension:

a) Stage 1 - Patients may use low intensity training to keep their blood pressure level in check on opposed to the use of medication.

b) Stage 2 - Patients may have some organ damage due to increased pressure over time including left ventricular hypertrophy. For these patients an exercise program should consists of aerobics but no heavy straining or lifting.

c) Stage 3 - For patients with advance blood pressure and heavier organ and heart damage exercise itself in contraindicated.

Contraindications of individual with hypertension :

a) Training contraindications include systolic BP>175 mm Hg. Training should be postponed until this number is lowered to below 140 mm Hg.

b) Exercising without consent of physician is also contraindicated.

c) All persons training in a health club who have hypertension should be under the care of a physician. Instructor should be aware of all physical limitations (perceived exertion orthopaedic etc.) before working with any hypertensive patient.

Type of exercise program for an individual with arthritis :

The most common exercise program is the PACE exercise routine, And I also believe in this, because this is the safest exercise program for Arthritis individual's.

Suggest the individual according to PACE program that aerobic activities (low impact or without impact) 2-Days a week, and followed by the Body conditioning with moderate weight, incorporating range of motion (ROM) 2 days a week.

And also will put him/her in light flexibility five to ten minutes before and after each session.

According to the condition of the client the program can be modified more and also can give them the same exercises for 5 to 6 days also.

Exercise Program for a client with asthma :

a) Warm up - Deep breathing exercise, abdominal breathing, breathing through the nose 5 minutes stretching, range of motion exercise.

b) Resistance Training Program -

Body Parts 2 sets of 10 Reps each exercise
Chest                                    Bench press/
Shoulders                              Shoulder press/overhead
Back                                     Lat pulls, reverse flys, shrugs
Abdominal                              Machine crunches
Biceps                                   Dumbbell biceps curls
Triceps                                  Triceps kickback
Hips/Adductors                       Total hip or abductor/adductor
                                           Middle Back Rows

Cool Down - More respiratory work, plus walk recovery and flexibility.

Classifications of Cardiac exercise programs :

Stage - 1 - Programs denote patients who have just had surgery and are using exercise for first time. Aerobic instructors will probably not be working with this group, as they are physician assisted, and therein with use of heart monitors which record EKG response to training.

Stage - 2 - Patients are past the initial stage of medical intervention, and some that are a symptomatic may participate in outpatients programs. Some will wear 24 hours monitors and heart rate strips that are then checked by phone hook-up to a physician's office.

Stage - 4 - Patients are basically self-paced with their exercise and schedule regular visits with their exercise and cardiology team.

Cystic Fibrosis :

This is a common fatal genetic disease. It is characterized by the following traits : an increase in electrolytes suggesting a defect in cellular transport mechanisms and pancreatic insufficiency. This impairs growth and reduces absorption of nutrients and in the major cause of morbidity (which is impaired pulmonary mucous clearance) and subsequent infections of the respiratory tract.

Cystic Fibrosis is an insidious disease. Its affects on women are greater than that of men, showing a 2:1 mortality ratio in comparison.

Exercise would be beneficial for individuals with cystic fibrosis disease -

a) Warp up - Diaphragmatic breathing (abdominal breathing) minimum of 10 to 15 slow breaths for approx. 2 minutes. Low intensity cardiovascular works (treadmill, cycle or rowing machine), 5 to 8 minutes.

b) Weights Exercise (Basic) for all the body parts -
= 2-3 sets each part
= 8-10 reps each set

c) Cool down - A recommended program is more cardiovascular exercise (5-8 minutes) coupled with stretching and flexibility work and 10-15 repetitions of rhythmic diaphragmatic breathing exercise.

Exercise is not a cure for clients that suffer from Cystic Fibrosis. It is only the means to help CF patients improve their lung function and heighten their awareness about the benefits of fitness.

Important precautionary measures to consider concerning exercise and children -

a) Make sure medical clearance has been obtained.
b) Determine the appropriate level of participation
c) Insure appropriate shoes are worn.
d) Instruct children how to breath properly during exercise.
e) Give class orientation, describe the day's activities and
teach a healthy message.
f) Have children hydrate before, during and after exercise.

Immediate Benefits of exercise for children -

a) Improved ability to meet the demands of daily physical activity.
b) Improved results in Physical Performance tests.
c) Improved motor skills.
d) Reduced Injuries
e) Fewer chronic health conditions and a lower risk for developing chronic health problems than sedentary children introducing fitness for preschool years.

Contraindications to Exercise for (5-12 years) children :

a) Training at too high level of intensity and for long duration.
b) Training in hotter and more humid environment as thermo regulatory mechanisms in the child's body are not fully developed.
c) Sports injuries are problematic in this group.

Contraindications to Exercise for Pregnant woman -

a) Pregnancy induced hypertension.
b) Pre-term rupture of membranes
c) Pre-term labor during a prior or current pregnancy or both.
d) Incompetent cervix or a cerclage.
e) Persistent second or third trimester bleeding.
f) Intrauterine growth retardation.

Medications that reduces blood pressure both at rest and during exercise :

Beta Blockers - is the agent that reduces blood pressure both at test and during exercise.

a) Trade Name : Inderal, Lopressor, Corgard, Tenormin, Visken, Blocadren, Sectral, Cartrol, Kerlone, Zebeta tevatol.
b) Major use : Treatment of angina, arrhythmia, hypertension and Migraine headaches.
c) Mechanism of Action : Beta blocks receptors of the sympathetic nervous system leading to a reduced blood pressure both at rest and during exercise, as well as a decreased exercise heart rate.

Name of the medication that is used to normalize rhythm disturbances :
All Anti-arrhythmic drugs are used to normalize rhythm disturbance, however, they act in diverse ways.

Precautions should take as a trainer :

Individuals receiving anti-arrhythmic drug therapy should contact physician before beginning an exercise program. This is not an area in which to take chances.


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