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

NASM study guide chapter 16

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Chapter 16 NASM study guide

Age considerations

  • Adolescents, as well as children, should get one more hour of daily physical activity compared to 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 as well as 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 in regards to exercise.
  • Degenerative aging primarily affects walking as one of the most 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 to perform exercise daily. Flexibility training is important.
  • Be aware of foot microtrauma as well as blisters as they can easily cause infection.
  • The biggest goal is for glucose control. As exercise will improve one’s 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 have strong effects on the blood pressure of your client 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 need to 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 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 in order 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 press or squat.
  • 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 out with only five minutes of exercise at the beginning 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.
  • It’s not advised to use plyometric techniques for the second or third trimester’s.
  • 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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Chapter 16 NASM practice quiz

Quiz Answer Key

Q1:  All of the following flexibility exercises are recommended for pregnant women except:
A1:   Dynamic stretching

Q2:  Which of the following populations should avoid the Valsalva maneuver?
A2:  Individuals with hypertension

Q3:  Which of the following is a potentially contraindicated exercise for someone with hypertension?
A3:  Floor bridge

Q4:  What assessments are appropriate for a client with hypertension?
A4:   Assessments using the talk test

Q5:  How ofter should you train clients that have osteoporosis?
A5:  2-3 days per week

Q6: What is the best rep range for clients with chronic lung disease
A6: 12-15

NASM flashcards for chapter 16

  • Priya says:

    Hi Tyler,
    Which practice exams would you recommend. I signed up for the basic self study course with NASM which has only 1 practice exam.
    I’ve looked at some books with practice exams, and according to some reviews, those seem to several errors and don’t cover all the topics.

    • Tyler Read says:

      Hey Priya,
      The team over at Trainor Academy have approximately five full practice exams that you can do for the NASM Exam. I have checked them out personally and they are quite good. I have also heard plenty of great feedback from lots of my students regarding how much these tests have helped them pass the exam. Check them out here

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