ACE 6th Edition Chapter 14: Exercise Considerations across the Lifespan

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Chapter Goals:

• Be able to describe the guidelines recommended for youth, women pregnant and in the postpartum period, and older adults. 
• List the risk factors for women that are pregnant or in the postpartum period to follow when they are exercising. 
• Apply the ACE IFT Model to youth, pregnant or postpartum women, and older adults.
• Discuss the unique benefits of muscular and cardio training for youth, pregnant or postpartum women, and older adults. 
• Be able to discuss the typical changes that occur physiologically and to the structure when aging. 

Introduction

Research has been used to establish the health benefits of exercising regularly. This has prompted healthcare professionals to now recommend physical activity in certain specific ways throughout the lifespan and in stages. 

People’s needs, goals, and capabilities change as they move through their life. Personal trainers need to be mindful of the different guidelines and main considerations for them to know regarding these stages.

The stages of life that will be expanded on will be youth, pregnant and postpartum women, and older adults. 

Exercise and Youth

Regular physical activity is important for overall health and fitness, and activity is just as important, or even more so, for the youth. 

Many of the youth in the united states now do not get the recommended levels of activity, which puts them at a greater risk of developing diseases later in their adult years. 

Only 20 – 26% of youth are now reaching recommendations for physical activity throughout the US.

Many of these declines have been caused by the school systems lowering their requirements for physical activity, and then partnered with the rising use of video games in the home and watching increased amounts of television, the youth are put at a decreased chance of reaching these requirements. 

All of the negatives we discussed in the last chapter have higher chances of coming up in adulthood when the youth are not active and meeting their recommendations. 

Exercise Guidelines for Youth

The number of facilities focused on youth and exercise programs is increasing with the need for organized youth activity. Youths can benefit by doing bouts of moderate and vigorous intensity activities that add up to 60 minutes or more daily. 

Inspiring today’s children to become more active will require a deeper understanding of their motivations and interests. 

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The competitive atmosphere of sports and recreational activity can be defeating for some kids that are less apt at performing motor skills. 

We must adapt to the child and ensure that they are having fun when they are performing activities. 

Muscular training is one of the things that can be seen as not great for kids to take part in. for this reason, we have these guidelines set for those youth that wish to perform muscular training.

• Children should make sure to be well supervised and use the right technique throughout the program at all times. Many machines will not be appropriate for use by kids due to their big differences in body size. 
• Never encourage children to perform one rep max lifts, sudden explosive movements, or compete with the other children when muscular training.
• Teach the children how to breathe when they are lifting properly. 
• Encourage the children to drink the right amount of fluids and stay hydrated before, during, and after the exercise sessions. 
• Tell children to communicate well with their trainers when they are feeling tired, fatigued, or when there is some form of discomfort or pain. 
• Create a dynamic, fun, and age-appropriate program for muscular training.

We should break up the differences in youth into preschool, school-aged, and adolescents. 

Even though physical activity may threaten the health of the youth through overuse injuries and sports related trauma occurring in sport specialization and year round single sport play. 

Applying the ACE IFT Model to Youth

A fun, playful, and engaging program, even for older teens, will be an important part of training youth. 

The training program should have movements in all planes of motion and use different types of equipment throughout the program. 

Aerobic exercise should be done daily at a moderate intensity with possible vigorous intensity work 3 days per week. This should be part of the 60 minutes or more per day and the type of exercise should be enjoyable and developmentally appropriate for the age group.

Resistance exercise should be 3 or more days per week and use body weight as the resistance in a scheme of 8 – 15 reps per exercise to a moderate fatigue level. This should be part of the 60 or more minutes per day of exercise and the type should be muscle strengthening physical activities that are not too structured. 

Bone strengthening exercise should be 3 o more days per week and the intensity is up in the air. This should also be part of the 60 minutes per day that is done, including jumping, running, basketball, and other training styles like this. 

Exercise for Women during Pregnancy and the Postpartum Period

The stance used to be that the medical community encouraged pregnant women to reduce their levels of physical activity and refrain from any form of vigorous exercise programs due to the concerns of harming the fetus. 

Now, however, we have more research into this, and the stance is that women can exercise without harming the fetus. 

Regular exercise when pregnant is also associated with reducing some of the harmful conditions that can often accompany pregnancy. 

It is important for personal trainers to request medical clearance from the client’s physician if the woman is severely obese, has gestational diabetes, or has hypertension. Some of the chronic conditions may worsen during pregnancy and can be difficult to control.

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Women will undergo many changes during their pregnancy, which must be considered. The hormone levels are where we see the greatest changes, along with the likely gain of around 25 – 30 pounds. 

Pregnant women’s cardiac reserve is reduced when they are training, and cardiac output is raised. 

Thermoregulation is one thing that is affected in pregnancy and slightly improves women’s ability to dissipate heat. 

Exercise Guidelines for Women During Pregnancy

Women who were previously active may continue their exercise program as before. The upper levels of safe exercise intensity have not yet been established. 

Women who have not been previously active should begin slowly and progress to moderate exercise. Some of the women will begin with lower intensities, around 10 minutes or less, and perform bouts of exercise throughout the day. 

We should utilize the talk test to ensure more effective means than heart rate to monitor exercise intensities. Staying below the VT1 shows a moderate intensity level.

We should avoid the use of high risk trauma to the abs from contacts or falls. So, sports or activities with these increased risks need some caution. 

Focus on hydration and balancing caloric intake with the metabolic demands of exercise and pregnancy. 

Some pregnant women may benefit from a small snack before exercise to help avoid hypoglycemia.

Applying the ACE IFT Model During Pregnancy

Aerobic training can be done 3 – 5 days per week or more and at a moderate intensity, with vigorous intensities being done for women who were highly active before their pregnancy. The time of exercise should be 30 minutes per day for a total of 150 minutes in the week or 75 minutes for vigorous intensities and the type should be a variety of weight and non-weight bearing activities

Resistance training should be done 2 – 3 days a week, but not in a row and at an intensity that allows for multiple Submax reps. One set should be done per exercise for those starting out, and 2 – 3 sets for intermediate and advanced clients using machines, free weight, and body weight exercises. 

Flexibility should be done on 2 – 3 days or more per week, with the intensity allowing us to stretch to the point of tightness or slight discomfort. We should hold static stretches for 30 seconds and do a series of static and dynamic flexibility exercises for each muscle-tendon unit. 

Postpartum Exercise Guidelines

We should obtain clearance from a physician and the guidelines they suggest for the client before resuming or starting an exercise program if medical or surgical complications exist. 

It would be best to start slowly and gradually, increasing the duration, frequency, and intensity. This will also depend on the client’s personal goals, energy levels, and physical activity levels before pregnancy. 

20 – 30 minutes per day of waking and simple exercises are a good idea.

Women should stop the session if unusual pain is felt or consult their physician afterward. 

Exercise should be stopped, and medical evaluations sought out if there is heavy bleeding.

These clients need to drink plenty of water and eat healthily. 

Exercise and Older Adults

Regular physical activity is needed for all people, including older adults. The older adults of today from the baby boomer generation are likely to retain their desire to stay active, but this may not remain for the future older adult populations.

Physiologically, aging results will normally include a decline in fitness levels, loss of height, reductions in lean body mass, loss of skin and connective tissue elasticity, lowered healing, changes in eyesight, and reductions in coordination. 

Some other notable changes come in the cardiovascular, endocrine, respiratory, and musculoskeletal systems. And these natural effects of aging may be compounded when there are chronic diseases present. 

Structural Changes in Aging

Muscle mass decline is one of the major structural changes that really reduces the capacity for muscular strength and endurance. More often than not, this has more to do with the lifestyle changes that occur when we reach older ages. 

The bones will become more fragile and porous in our advancing years, putting older adults at risk for fractures and bone problems. 

With the decrease in muscle mass, we often see an increase in body fat levels. These changes will affect the basal metabolic rate, and the insufficient physical activity often seen will have a role here too. 

Stability and Balance for Older Adults

When people get older, balance and coordination tend to decrease, increasing the risk of falling and injuries occurring from these falls. This is all due to the loss of muscle and the decline in proprioception. 

FITT Recommendations for Older Adults

Aerobic exercise should be done 5 or more days per week when doing moderate intensity and 3 or more days per week for vigorous intensity work. The time should be 30 – 60 minutes daily for moderate intensity and 20 – 30 minutes for vigorous intensities. Any modality of exercise should be done. 

Resistance training should be done on 2 or more days per week and the intensity should be light for beginners and then progress all the way to vigorous over time. The time should see 8 – 10 exercises that use all of the major muscle groups for 1 – 3 sets of 8 – 12 reps each. Make use of weight bearing activity for building strong bones. 

Flexibility training should be done on 2 or more days per week, and stretching should be done to the point of feeling tightness or slight discomfort. The stretches should be held for 30 – 60 seconds and any flexibility modality that can be done should be done.