Here are some medical conditions that may complicate general exercise prescriptions. Elderly individuals- Special considerations must be made for the elderly since they experience a number of decreased abilities as they increase in age. Most elderly they need an extended building up period when beginning a new exercise program. Low intensity exercises are recommended due to the high prevalence of functional limitations. Diabetes- Clearance from their doctor is needed. Glucose related medication requirements are likely to change with participation in an exercise program. Non-weight bearing exercises are recommended because many diabetics are at risk for foot ulcerations, peripheral vascular disease and others. Blood sugar should be checked more often- before and after work-outs. Arthritis and Other Rheumatic Diseases- Regular exercise can reduce joint pain and stiffness and increase flexibility, muscle strength, cardiac fitness and endurance in individuals with arthritis. Physical Therapist and occupational therapist can recommend exercises that are helpful for particular types of arthritis. 3 different type's exercises that are often cited for people with arthritis are ROM exercise, resistance training and aerobic exercise. Osteoporosis- Physician approval should be obtained before prescribing a exercise routine. This includes frail individuals or those who are prone to fall, and those who have fractures. Avoid activities that require spinning of the spine or that are high-impact, and bending from the waist down. Primary concerns with individuals with osteoporosis are avoiding fractures, and preventing falls is essential to the goal. Cardiovascular Disease- It is well known that regular exercise has powerful benefits for both preventing and treating CVD. However, it is also well known that an acute bout of exercise particularly in sedentary individuals can precipitate a cardiac event in those with preexisting CVD. Thus these individuals fitness beginnings must be initiated both with physician approval and input. Starting slow is essential for patients with CVD. They must be taught the warning signs of acute cardiac events such as chest pain, unreasonable shortness of breath, and tingling in jaw or left hand. Chronic Lung Disease- is a general term used to describe long-term illnesses of respiratory system, including asthma, chronic bronchitis, and emphysema. This group stands to benefit from starting slow and increasing intensity as improvements are made. When working with anyone who has any sort of Chronic Lung Disease, be sure to have plenty or rescue medication near. This is particularly true for individuals with asthma. Cancer- Evidence suggests that physical activity can improve various quality of life parameters, including fatigue and depression, both during and after treatment. Physician must approve and constantly be updated, due to the complexities of treatment, (short term-long term) and side effects from treatment Mitigating factors may make exercise unwise or dangerous for some. Sometimes the risk-benefit ratio may be higher and close medical supervision may be required. Anemia, immune compromised conditions, low platelet count, severe nausea, balance issues, fever, and bone pain. Pregnancy- Regular exercise can play an important role in the health and well being of pregnant women. Women who exercise during pregnancy have reduced weight gain, more rapid weight loss after pregnancy, improved mood and improved sleep patterns, but it should only be done with a physician's knowledge. 30 minutes or more of moderate exercise is recommended on most if not all days for women if they have not experienced any complications during their pregnancy. Women are encouraged to start an exercise program, but to start slowly being sure not to over exert themselves. Resistance training consideration- A preliminary orientation should establish appropriate weight loads and instruct the participant on proper lifting patterns to avoid straining and the Val Salva maneuver. Different exercises for postural deviations and other conditions can also be recommended. Catch up phase- Thought very little research supports, Low-to moderate-risk cardiac patients who wish to initiate mild to moderate resistance training should first participate in a traditional aerobic exercise program for a minimum of 2-4 weeks.
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