Exercise Science

1
Exercise Science

• Training
• Special Populations

2
Training Special Populations

• Special 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

3
Training Special Populations

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

4
Training Special Populations

• Hyperlipidemia (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

5
Training Special Populations

• Hyperlipidemia 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

6
Training Special Populations

• Hypertension
• 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

7
Training Special Populations

• Hypertension 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

8
Training Special Populations

• Hypertension 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

9
Training Special Populations

• Cerebral Vascular Accident (stroke)

10
Training Special Populations

• Cerebral Vascular Accident (stroke)

11
Training Special Populations

• Cerebral 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

12
Training Special Populations

• Arteriosclerosis
• 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.

13
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.

14
Training Special Populations

• Coronary (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.

15
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

16
Training Special Populations

• Peripheral 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!!!

17
Training Special Populations

• Peripheral 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)

18
Training Special Populations

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

19
Training Special Populations

• Hypoglycemia
• 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

20
Training Special Populations

• Hypoglycemia 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

21
Training Special Populations

• Insulin 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

22
Training Special Populations

• Non-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

23
Training Special Populations

• Gestational Diabetes Mellitus
• A form of Type II diabetes
• Manifests during pregnancy
• Ceases post gestation
• Prone to Type II diabetes
• in later life

24
Training Special Populations

• Diabetes 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

25
Training Special Populations

• Diabetes 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

26
Training Special Populations

• Pulmonary Disorders
• Asthma
• Bronchitis (COPD)
• Emphysema (COPD)

27
Training Special Populations

• Asthma
• 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

28
Training Special Populations

• Asthma 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)

29
Training Special Populations

• Bronchitis (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.

30
Training Special Populations

• Emphysema (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.

31
Training Special Populations

• Bronchitis 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

32
Training Special Populations

• Bone or Joint Disorders
• Osteoarthritis
• Rheumatoid Arthritis
• Osteoporosis
• Chronic Low Back Pain

33
Training Special Populations

• Osteoarthritis
• 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.

34
Training Special Populations

• Rheumatoid 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.

35
Training Special Populations

• Arthritis 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

36
Training Special Populations

• Osteoporosis
• 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.

37
Training Special Populations

• Osteoporosis 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

38
Training Special Populations

• Low 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.

39
Training Special Populations

• Low 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

40
Training Special Populations

• Miscellaneous Disorders
• Cancer
• Aging
• Obesity (Over Weight)
• Children

41
Training Special Populations

• Cancer
• 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

42
Training Special Populations

• Cancer
• 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

43
Training Special Populations

• Cancer Exercise Guidelines
• Adjust activity to individuals 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

44
Training Special Populations

• Aging
• 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, and
• joints helps to relieve the pain of arthritis
  reduces symptoms of anxiety and
• depression and can decrease the need for
  hospitalizations, physician visits, and
• medications.
• People tend to be less active as they age.

45
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

46
Training Special Populations

• Aging Exercise Guidelines
• Physical activity does not need to
• be strenuous to be
• beneficial 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

47
Training Special Populations

• Obesity (Over Weight)
• On any given day 1 out of every 4 Americans is on
  a diet
• Among adults aged 2074 years the prevalence of
  obesity increased from 15.0 (in the 19761980
  survey) to 32.9 (in the 20032004 survey).
• Weight Management Industry 40 billion
• 95 of those who lose weight will be
• unsuccessful in keeping it off.

48
Training Special Populations

• Obesity (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)

49
Training Special Populations

• Obesity (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

50
Training Special Populations

• Children
• 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.

51
Training Special Populations

• Children 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