ACE 6th Edition Chapter 14: Exercise Considerations across the Lifespan
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ACE 6th Edition Chapter 14: Exercise Considerations across the Lifespan 1

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    Chapter Goals:

    • Be able to describe the guidelines that are recommended for youth, women who are 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.
    • Be able to discuss the unique benefits of muscular and cardio training for youth, women that are pregnant or postpartum, 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, and this has prompted the healthcare professionals to now recommend physical activity in certain specific ways throughout the lifespan and in stages. 

    The needs, goals, and capabilities of people change as they move through their life and it is essential for personal trainers 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, women who are pregnant and postpartum, 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 then works to put them at a greater risk for 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 raising 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

    With the increases in the need for organized youth activity, the number of facilities that are focused on youth and the exercise programs are all increasing. Youth can have many benefits by doing bouts of moderate and vigorous intensity activities that add up to 60 minutes or more each day. 

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

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

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    It is important that we adapt to the child and ensure that they are having fun when they are performing activity. 

    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 movements that ae explosive, or to compete with the other children when muscular training.
    • Teach the children how to properly breathe when they are lifting. 
    • 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 by the groups of preschool-aged children, school-aged children, and adolescents. 

    Even though physical activity may be a threat to 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 program that is fun, playful, and engaging, even for older teens, is going to be the important part for training youth. 

    The training program should have movements in all the 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, and it should include the 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 are able to exercise without bringing any harm to 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 hypertension. Some of the chronic conditions may worsen during pregnancy and can be difficult to control.

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

    The cardiac reserve is reduced in pregnant women when they are training, and the cardiac output is raised. 

    Thermoregulation is one of the things that are affected in pregnancy and results in a slight improvement in women’s ability to dissipate heat. 

    Exercise Guidelines for Women During Pregnancy

    Women that were previously active may continue their exercise program as it was 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 a moderate level of 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 will need to have some caution. 

    Focus on the 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 for 3 – 5 days per week or more and at a moderate intensity, with the vigorous intensities being done for the women that 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 the vigorous intensities and the type should be a variety of weight and non-weight bearing activities

    Resistance training should be done on 2 – 3 days in the 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 and the use of machines, free weight, and body weight exercises. 

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    Flexibility should be done on 2 – 3 days or more per week with the intensity being one that allows for 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 are there. 

    You should start slowly and gradually increase the duration, frequency, and then the intensity. This will also depend on the personal goals and energy levels of the client along with their levels of physical activity prior to pregnancy. 

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

    Women should stop the session if there is unusual pain felt or consult their physician after it occurs. 

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

    It is important for these clients to drink plenty of water and eat healthily. 

    Exercise and Older Adults

    Regular physical activity is needed for all people, and this includes 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, the results of aging will normally include a decline in the fitness levels, loss of height, reductions in lean body mass, the 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 from aging may be compounded when there are chronic diseases present. 

    Structural Changes with Aging

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

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

    With the decrease in muscle mass, we often see an increase in the 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, and this increases the risk for falling and injuries occurring from these falls. This is all due to the loss of muscle and the declines 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 the vigorous intensity work. The time should be 30 – 60 minutes per day of moderate intensity and 20 – 30 minutes for the 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.

    ACE 6th Edition Chapter 14: Exercise Considerations across the Lifespan 2
    ACE CPT Chapter 1: Role and scope of practice for the personal trainer 2
    ACE 6th Edition Chapter 14: Exercise Considerations across the Lifespan 3

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