NASM 6th Edition chapter 16 – Chronic Health Conditions and Physical or Functional Limitations

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Chapter 16 NASM study guide

Age considerations

• Adolescents and children should get one more hour of daily physical activity than adults.

Adults and children: the psychological differences

• Children don’t produce high levels of glycolytic enzymes and cannot maintain high-intensity exercise as well.
• Children don’t show a plateau in oxygen uptake. It’s more appropriate saying peak oxygen uptake.
• Children are less efficient as they usually exercise at a high percentage of peak oxygen uptake while performing a submaximal exercise.

Youth resistance training

• Children that have never trained can increase their strength by 30% to 40% in as little as eight weeks.
• Unlike common misconceptions, resistance training is effective and safe for children and adolescents.
• 1 to 2 sets, 8 to 12 repetitions, 40% to 70% of one rep max, two to three days per week.

Training seniors

• Seniors that do not have a history of chronic conditions respond very similarly to healthy young adults regarding exercise.
• Degenerative aging primarily affects walking as one of the essential functional activities.
• Losing musculoskeletal tissue is not completely age-related.
• When training seniors, you should monitor them very closely and progress them slowly. If your client cannot do self-myofascial release, slow active or dynamic stretches should be done instead. Exercises should be progressed to standing or free sitting exercises if possible.
• 1 to 3 sets, 8 to 20 repetitions, 40% to 80% of one rep max, 3 to 5 days per week.

Working with obese clients

• Core training is crucial for obese clients.
• Sometimes, machines and free weights can be difficult. Resistance bands are a good option.
• When doing flexibility training, performing them from a seated or standing position is preferred.
• 1 to 3 sets, 10 to 15 repetitions, 2 to 3 days per week.

Working with clients with diabetes

• Should follow similar guidelines to that of obese clients. Lower-impact exercises should be used.
• As recommended, perform exercise daily. Flexibility training is important.
• Be aware of foot microtrauma and blisters, which can easily cause infection.
• The biggest goal is glucose control, as exercise improves insulin sensitivity. This is a very positive effect on people with type II diabetes.
• 1 to 3 sets, 10 to 15 repetitions, 2 to 3 days per week.

Working with clients with hypertension

• It’s important to pay attention to the body position of clients with hypertension the whole session. One’s body position can strongly affect your client’s blood pressure both during the session, before the session, and after the session.
• You should completely avoid heavy lifting. Prevent your client from clenching their fist or over-gripping weights. You must modify the exercise tempo to avoid prolonged concentric and eccentric actions. Always perform the exercise seated or standing. Let your client stand up slowly to prevent dizziness. You should always progress these clients slowly.
• Avoid using the Valsalva maneuver.
• The talk test fitness assessment is the most appropriate.
• 1 to 3 sets, 10 to 20 repetitions, 2 to 3 days per week

Working with clients with coronary heart disease

• Continually monitor your client’s heart rate to stay below the upper limits.
• Consider that your client may also suffer from other diseases such as hypertension, obesity, diabetes, or peripheral vascular disease.
• Modify the tempo of exercises to avoid prolonged eccentric and concentric movements.
• Avoid lifting heavy.
• Prevent your client from clenching or over-gripping weights.
• Always perform exercises standing or seated.
• 1 to 3 sets, 10 to 20 repetitions, 2 to 3 days per week.

Working with clients that have osteoporosis

• Focus on your client’s postural control.
• Progress with osteoporosis clients should be slow.
• If possible, progress your clients to standing or free sitting exercises.
• Focus your training on their arms, back, thighs, and hips.
• Avoid additional spinal loading on exercises such as leg presses or squats.
• 1 to 3 sets, 8 to 20 repetitions less than 85% of one rep max, 2 to 3 days per week.

Working with clients that have arthritis

• Avoid using high repetitions and heavyweight.
• Keep your client within the range of motion that is pain-free.
• It is possible to start with only five minutes of exercise and then progress from there.
• 1 to 3 sets, 10 to 12 repetitions, 2 to 3 days per week.

Working with clients that have cancer

• Initially, avoid heavy lifting.
• Make sure your client has adequate rest between sets.
• Progress your client slowly.
• Do not use self-myofascial release for clients that are doing radiation or chemotherapy. Only use myofascial release if they can tolerate it.
• 1 to 3 sets, 10 to 15 repetitions, 2 to 3 days per week.

Working with pregnant clients

• Make sure to stay away from exercises in supine or prone positions after the 12-week mark.
• Avoid self-myofascial release where they have areas of swelling or varicose veins.
• Using plyometric techniques for the second or third trimester is not advised.
• Do not use dynamic stretching for flexibility training.
• 1 to 3 sets, 10 to 15 repetitions, 2 to 3 days per week.

Working with clients with chronic lung disease

• The most important thing is to allow adequate rest between sets.
• 12 to 15 repetitions, 2 to 3 days per week.

Working with clients with peripheral/claudication arterial disease

• Allow for adequate rest between sets.
• Progress your client slowly.
• Walking on the treadmill is a preferred exercise.
• The biggest limiting factor for these clients is leg pain.
• One set, 8 to 15 repetitions, 2 to 3 days per week.

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NASM flashcards for Chapter 16