Professional Documents
Culture Documents
DPT, MSCPPT
(RIU)
LECTERER ZIHS
SPECIAL POPULATION
It is often meant as a collective term for a group of
people with certain health-related conditions or
groups of individuals who exhibit medical conditions
that impair health and functional ability
OR
Patients with circumstances or conditions that require
special attention
Special Populations
Cardiac
Elderly
Diabetes
Hypertension
Osteoporosis
Chronic Obstructive Pulmonary Disease
Asthma
Pregnancy
Exercise and the Elderly
Treatment
Cromolyn sodium
2-agonists
Theophylline
Exercise prescription
Treatment
-agonist
Chronic Obstructive Pulmonary
Disease (COPD)
Includes chronic bronchitis, emphysema, and
bronchial asthma
Can create irreversible changes in the lung
Can severely limit normal activities
Treatment includes:
Medication (including supplemental O2)
Breathing exercises
Dietary therapy
Exercise
Testing and Training COPD Patients
Medical exam including exercise testing
FEV1 : It represents the proportion of a person's vital capacity
that they are able to expire in the first second of forced
expiration..
VO2max
Maximum exercise VE
Blood gasses (PO2 and PCO2)
Precautions
Blood pressure should be monitored for those on
medications
Hypertension
ACSM Guidelines, Gordon 1997
Medications
-blockers (reduce work of the heart)
Anti-arrhythmics (control dangerous heart rhythms)
Nitroglycerine (reduce angina symptoms)
Cardiac Rehabilitation Testing
Graded exercise testing
Blood pressure
Rating of perceived exertion (RPE)
Signs or symptoms (chest pain)
Determination of myocardial blood flow
Cardiac rehabilitation includes a "Phase 1” inpatient
exercise program that is used to help the patients make
the transition from the cardiovascular event (e,g" a
myocardial infarction that put them in the hospital) to the
time of discharge from the hospital
Safety
Fitness
Risk factor management
Cardiac Rehabilitation: Exercise Programs
Exercise prescription
Based on GXT results
MET level, heart rate, signs/symptoms
Whole body, dynamic exercise
Intensity, duration, and frequency based on severity of
disease
Effects
Increased functional capacity (VO2max)
Reduced signs/symptoms of ischemia
Improved risk factor profile
Termination Criteria from Exercise
Any angina symptoms or feeling too breathless to
continue
Feeling dizzy or faint
Leg pain limiting further exercise
Exceeds level of perceived exertion > 15 (Borg
Scale)
Contraindication for Exercise
Unstable or unresolved angina.
Fever and acute systemic illness.
Patient in severe pain.
Resting blood pressure: SBP>
180mmHg, DBP> 100mmHg
Significantly unexplained drop in
blood pressure.
Tachycardia
New or recurrent symptoms of
breathlessness, palpitation,
dizziness.
Significant lethargy
Osteoporosis
Osteoporosis is a loss of bone mass that primarily affects
women over fifty years of age and is responsible for 1.5 million
fractures annually
Glucose monitoring
During/after exercise
Carbohydrate intake
During recovery
Exercise and Type 2 Diabetes
Blood glucose monitoring
Exercise prescription
4-7 times per week
Promotes weight loss and sustained increase in insulin
sensitivity
Minimum of 1,000 kcal/wk
From all physical activity
American
Diabetes
Association