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Chapter 18 – Clients Who Are Preadolescent, Older, or Pregnant

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    Chapter Objectives:

    • Discuss the developmentally appropriate physical activity programs for preadolescents that demonstrate understanding for age-specific needs and concerns.
    • Describe the health benefits of exercising as a senior and outline the exercise guidelines for older adults.
    • Talk about exercise recommendations and precautions for pregnant women.

    Preadolescent Youth

    Preadolescent youth is defined as the time before the development of secondary sex characteristics, also called puberty. This is roughly 6 – 11 for girls and 6 – 13 for boys.

    Youth should be encouraged to participate in physical activities regularly. These skills will help to enhance endurance, strength, flexibility, and skills relating to fitness.

    Academic achievement may also increase when participating in school-related things.

    This promotion of physical activity for preadolescents is a major deal because of the rise in childhood obesity and cases of being overweight. So, activity would serve to keep this lower.

    Youth Physical Activity

    Children should not follow any kind of adult exercise program, as their needs are completely different.

    Children are used to sporadic bursts of moderate and vigorous exercise with brief times of low intensity activity or even rest when its needed.

    The assumption that children are inactive due to them not following a plan and being active more sporadically is inaccurate. 

    There are less noticeable changes that occur in children from regular standardized exercise, and thus these programs forced on children may demotivate them.

    Children have higher breathing frequencies and lower tidal volumes when compared to adults.

    Children have higher heart rates and lower stroke volumes in all types of exercise.

    Metabolic specialization isn’t found in children as much, so the strongest child is often the one with the most endurance, too.

    Youth should be recommended to engage in 60 minutes or more of physical activity as part of play, games, sport, transportation, and school activities.

    Resistance Training for Youth

    Resistance training is now known to be safe, effective, and worthwhile for the conditioning of preadolescents.

    Muscle Strength Gains and Other Benefits

    Studies show that children are able to increase strength above and beyond the growth and maturation when doing a well designed program. Strength gains of 30 – 40% have been seen in children after short term programs.

    Neural adaptations are the typical thing responsible for the strength gains.

    Children that are overweight will most benefit form resistance based training.

    Reducing Sport Related Injuries

    There is not a lot of research on this subject, but it is assumed that since this training makes a more powerful child, then it should be assumed that it would reduce their injury rate like it does with adults.

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    Very few adolescents are ready for sport practice and competition. 42% based on research.

    Guidelines for Youth Resistance Training

    It is important to begin at a level that is equal to their physical abilities. Often the volume and intensity exceed the abilities of the child and the rest periods that are prescribed between workouts are too short for the proper amount of recovery.

    The general guidelines are things like:

    • Qualified adults should provide supervision and instruction. 
    • The training environment should be safe and free of hazards. 
    • Resistance training should be preceded by a 5- to 10-minute dynamic warm-up. 
    • One to three sets of 6 to 15 repetitions should be performed on a variety of exercises. 
    • Include exercises for the upper body, lower body and midsection. 
    • Increase resistance gradually (e.g., about 5% to 10%) as strength improves. 
    • Resistance train two or three nonconsecutive days per week. 
    • Children should cool down with less intense calisthenics and static stretching. 
    • Vary the resistance training program over time to optimize gains and prevent boredom. 

    Teaching Preadolescent Youth

    Some recommendations for personal trainers that train children are:

    • Provide close supervision and listen.
    • Speak to the kids using words they know.
    • Greet each child by name when they arrive.
    • Praise the kids for doing well.
    • Realize training children is different from adults.
    • Design activities for equal participation and fun.
    • Gradually progress the programs.
    • Play down competition and focus on skills, successes, and fun.
    • Remind the kids to take time to learn the skill.
    • Offer many activities and regimentation.
    • Emphasize the importance of adequate hydration.
    • Inform parents about the benefits.

    Older Adults

    This is defined as men and women that are 50 and older. We also say, seniors.

    Benefits of Aerobic Training

    Older adults receive the greatest benefit from aerobic training than any other age group.

    Standard cardio can increase VO2 by 17% and higher intensity can go up to 25%. 

    Other benefits are reduced risks for many of the dangerous diseases that increase with age.

    Benefits of Resistance Training

    Cardiovascular Disease

    Resistance training is safe and productive for improving fitness and performance of older adults with cardiovascular disease. They also maintain desirable body weight and positive self-concept.

    Colon Cancer

    Training increases the rate of food moving through the gut and thus positively reduces the risk of colon cancer.

    Type 2 Diabetes

    Type 2 diabetes is reduced due to the health benefits that come from training. A major deal is the improved insulin response that happens.

    Osteoporosis

    Resistance training helps maintain a strong musculoskeletal system and reduce osteoporosis.

    Low Back Pain

    Strengthening muscles will alleviate the lower back pain occurrences.

    Arthritis

    Stronger muscle will improve the joint function and reduce the arthritic discomfort.

    Depression

    Self-confidence increases counteract the depression for older adults.

    Muscle Loss and Metabolic Rate Reduction

    Muscle tissue is replaced more often, and the metabolism is recharged thus fighting both the muscle loss and metabolic rate reductions that might occur.

    Mitochondrial Function

    Circuit strength training has been shown to increase the mitochondrial content and oxidative capacity of the trained muscle tissues.

    Functional Abilities

    Regular activity leads to retention of functional abilities.

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    Resistance Training Guidelines for Seniors

    Older adults should do 2 – 3 nonconsecutive days of resistance training for the positive affects mentioned. 

    The movements should be controlled speeds and involve the full range of motion. 

    Beginners should begin very light and work their way up.

    Ranges recommended are 60 – 90% of max resistance. 

    Aerobic Endurance Training Guidelines for Seniors

    The frequency should be 2 – 5 days per week and should last 20 – 60 minutes per session. Typically, 75% intensity is recommended.

    Screening and Program Design for Seniors

    First you should check with the client’s physician for their guidelines and training modifications.

    Exercise Order

    Aerobic activity should be first, followed by resistance training, and then flexibility.

    Safety and Comfort

    Some conditions can affect the seniors’ comfort and safety of exercise. The Chart on page 484 shows them.

    Pregnant Women

    Benefits of Exercise During Pregnancy

    • Improved cardiorespiratory and muscular fitness 
    • Better recovery from labor 
    • Quicker return to prepregnancy weight, strength, and flexibility levels 
    • Reduced belly size postpartum 
    • More energy reserve 
    • Fewer obstetric interventions 
    • Shorter active phase of labor and less pain 
    • Less weight gain 
    • Improved mood and self-concept 
    • Reduced feelings of stress, anxiety, and depression 
    • Increased likelihood of adopting permanent healthy lifestyle habits 

    Fetal Response to Exercise

    Sometimes babies have reduced birth weight when mothers performed high intensity exercise throughout pregnancy. It may therefore be advised that pregnant women participate in moderate intensity exercise.

    Vigorous exercise also sees 5 – 15 beats per minute increased in fetal heart rate.

    Accommodating Mechanical and Physiological Changes During Pregnancy

    Cardiovascular Response

    Pregnant women should be able to hold a conversation and work at a 12 – 14 RPE level when going for the recommended moderate intensity.

    Respiratory Response

    Pregnant women increase their minute ventilation by 50% which results in 10 – 20% more oxygen utilized at rest. Less oxygen is available when working out, also.

    Breathing requires more effort and subjective workload and max exercise performance decrease.

    Mechanical Response

    Women’s center of mass changes throughout pregnancy, and this will affect their balance, body control, and movement mechanics. 

    Metabolic Response

    More oxygen is needed during pregnancy and thus more energy substrate. The women need 300 more calories to meet this new metabolic demand.

    Thermoregulatory Response

    Basal metabolic rate and heat production is affected by pregnancy and also increased through exercise.

    Contraindications for Exercise

    These present absolute contraindications to exercise:

    • Pregnancy-induced hypertension (pre- eclampsia) 
    • Ruptured membranes 
    • Premature labor during the current pregnancy 
    • Persistent bleeding after 12 weeks 
    • A cervix that dilates ahead of schedule (incompetent cervix) 
    • Significant heart disease or restrictive lung disease 
    • Multiple-birth pregnancy that creates a risk of premature labor 
    • A placenta that blocks the cervix after 26 weeks.

    These relative contraindications should be seen by the client’s physician before exercise participation:

    • Poorly controlled type 1 diabetes, seizures, hypertension, or hyperthyroidism 
    • Extreme morbid obesity 
    • Extremely low body weight (body mass index <12 kg/m2)
    • History of a very sedentary lifestyle 
    • Unevaluated maternal cardiac dysrhythmia
    • intrauterine growth restriction in current pregnancy 
    • Severe anemia 
    • Heavy smoking 
    • Chronic bronchitis 
    • Orthopedic limitations

    These are reasons to stop exercise and seek medical advice:

    • Any signs of bloody discharge from the vagina 
    • Dyspnea before exertion
    • Headaches or unexplained dizziness
    • Chest pain 
    • Muscle weakness
    • Calf pain or swelling
    • Preterm labor
    • Decreased fetal movement 
    • Amniotic fluid leakage 

    Exercise Guidelines

    The following apply to healthy women without any exercise contraindications:

    • Do 15 minutes of moderate physical activity every day and gradually progress to30 minutes on at least three, if not all, days of the week.
    • Resistance train major muscle groups without isometric contractions.
    • Avoid the supine position after the first trimester.
    • Don’t exercise past the fatigue point.
    • Rhythmic and dynamic activities are preferred for reducing the risk of injury.
    • Avoid sports with the potential for damage to the abdominal area.
    • Large body temp increases need to be minimized.

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    NSCA CPT Chapter 18 – Clients Who Are Preadolescent, Older, or Pregnant 1
    NSCA CPT Chapter 18 – Clients Who Are Preadolescent, Older, or Pregnant 2
    NSCA CPT Chapter 18 – Clients Who Are Preadolescent, Older, or Pregnant 3

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