Chapter 17: Exercise for Special Populations

OBJECTIVES

By studying this chapter, you should be able to do the following:

1. Describe the difference between type 1 and type 2 diabetes.

2. Explain why exercise may complicate the life of a person with type 1 diabetes, while being a recommended and primary part of a program for someone with type 2 diabetes.

3. Describe the changes in diet and insulin that might be made prior to a person with diabetes doing exercise.

4. Describe the cause of exercise-induced asthma, and how one may deal with this problem as part of an exercise prescription.

5. Contrast chronic obstructive pulmonary disease (COPD) with asthma in terms of causes, prognosis, and the role of rehabilitation programs in a return to “normal” function.

6. Identify the types of patient populations that one might see in a cardiac rehabilitation program.

7. Contrast Phase I with Phase II and Phase III cardiac rehabilitation programs.

8. Describe the physiological changes in older adults that result from an endurance-training program.

9. Outline the physical activity recommendations for older adults who cannot do the regular adult program.

10. Describe the guidelines for exercise programs for pregnant women.

OUTLINE

• Diabetes 387

  • Exercise and Diabetes 388

• Asthma 392

  • Diagnosis and Causes 392

  • Prevention/Relief of Asthma 392

  • Exercise-Induced Asthma 392

• Chronic Obstructive Pulmonary Disease 395

  • Testing and Training 395

• Hypertension 396

• Cardiac Rehabilitation 397

  • Population 397

  • Testing 398

  • Exercise Programs 398

• Exercise for Older Adults 399

  • Maximal Aerobic Power 399

  • Response to Training 400

  • Bone Health and Osteoporosis 402

  • Strength 403

• Exercise during Pregnancy 403

KEY TERMS

arrhythmias

beta-receptor agonist (β₂-agonist)

coronary artery bypass graft surgery (CABGS)

cromolyn sodium

diabetic coma

immunotherapy

insulin shock

ketosis

mast cell

myocardial infarction (MI)

nitroglycerin

percutaneous transluminal coronary angioplasty (PTCA)

INTRODUCTION

Chapter 16 presented some recommendations for planning an appropriate exercise program for the apparently healthy individual. Exercise has also been used as a primary nonpharmacological intervention for a variety of problems, such as obesity and mild hypertension, and as a normal part of therapy for the treatment of diabetes and coronary heart disease. This chapter discusses the special concerns that must be addressed when exercise is used for populations with specific diseases, disabilities, or limitations. However, the student of exercise science should recognize that this information is introductory in nature. See ACSM's Exercise Management for Persons with Chronic Diseases and Disabilities in Suggested Readings for a comprehensive look at this topic.

DIABETES

Diabetes is a disease characterized by hyperglycemia (elevated blood glucose) resulting from inadequate insulin secretion (type 1), reduced insulin action (type 2), or both (8). Diabetes is a major ...