Free Study Guide for the NASM CPT Exam Chapter 16 – Chronic Health Conditions and Physical or Functional Limitations

Age Considerations

  • Children and adolescents should get 1 hr or more of physical activity daily.

Physiologic Differences between Children and Adults

  • Children do not exhibit plateau in oxygen uptake, peak oxygen uptake is more appropriate.
  • Children less efficient, tend to exercise at higher percentage of peak oxygen uptake during submaximal exercise.
  • Do not produce sufficient levels of glycolytic enzymes to sustain bouts of high-intensity exercise.

Resistance Training for Youth

  • 1-2 sets of 8-12 reps at 40-70% of 1 RM 2-3 days per week
  • Resistance training is both safe and effective in children and adolescents.
  • Untrained children can improve strength by 30 to 40% in 8 weeks.

Seniors

  • 1-3 sets of 8-20 reps at 40-80 % of 1 RM 3-5 days/week
  • Older adults with and without other chronic health conditions can and do respond to exercise much in the same manner as apparently healthy younger adults.
  • Walking is one of most fundamental functional activities affected with degenerative aging.
  • Musculoskeletal loss not entirely related to aging.
  • Progression should be slow, well monitored, based on postural control. Exercises should be progressed if possible toward free sitting or standing. If client cannot tolerate SMR perform slow rhythmic active or dynamic stretches.

Obesity

  • 1-3 sets of 10-15 reps 2-3 days/wk
  • Flexibility exercises should be performed from standing or seated position, using standing hip flexor stretch rather than kneeling hip flexor stretch, standing hamstring stretch, wall calf stretch.
  • Core and balance training important for obese individuals.
  • May find it difficult to use machines, dumbbells, cables, exercise tubing work quite well.

Diabetes

  • 1-3 sets of 10-15 reps 2-3 days/wk
  • Most important goal is glucose control. Exercise improves insulin sensitivity. Positive effect on prevention of type 2 diabetes.
  • Take care to prevent blisters and foot microtrauma that could result in foot infection.
  • Daily exercise recommended. Flexibility exercises recommended.
  • Follow exercise guideline for obese adults. Lower impact exercise modalities.

Hypertension

  • 1-3 sets of 10-20 reps 2-3 days/wk
  • Important to monitor body position of clients with hypertension at all times. Body xenical oral position can have dramatic effect on blood pressure response before, during, and after exercise in clients with hypertension.
  • Avoid heavy lifting and valsalva maneuvers. Do not let client overgrip weights or clench fists. Modify tempo to avoid extended isometric and concentric muscle action. Perform exercises in standing or seated position. Allow client to stand up slowly to avoid possible dizziness. Progress client slowly.

Coronary Heart Disease

  • 1-3 sets of 10-20 reps 2-3 days/wk
  • Monitor pulse to stay below safe upper limit of exercise.
  • 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
  • Do not let client overgrip weights
  • Perform exercises in standing or seated position

Osteoperosis

  • 1-3 sets of 8-20 reps <85% of 1 RM 2-3 days/wk
  • Progress should be slow, well monitored, 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

Arthritis

  • 1-3 sets of 10-12 reps 2-3 days/wk
  • Avoid heavy lifting and high reps
  • Stay in pain-free ranges of motion
  • May be need to start out only with 5 mins of exercise and progressively increase

Cancer

  • 1-3 sets of 10-15 reps 2-3 days/wk
  • Avoid heavy lifting in initial stages of training
  • Allow for adequate rest intervals and progress client slowly
  • Only use SMR if tolerated, avoid SMR for clients undergoing chemo or radiation

Exercise and Pregnancy

  • 1-3 sets of 10-15 reps 2-3 days/wk
  • Avoid exercises in prone or supine position after 12 weeks
  • Avoid SMR on varicose veins and areas of swelling
  • Plyometric training not advised in second and third trimesters

Chronic Lung Disease

  • 12-15 reps 2-3 days/wk
  • Allow for sufficient rest between sets

Intermittent Claudication/Peripheral Arterial Disease

  • 1 set of 8-15 reps 2-3 days/wk
  • Allow for sufficient rest
  • Progress slowly
  • Treadmill walking preferred.
  • Primary limiting factor is leg pain.